Chin A Yi MD, Abstract Co-Author: Nothing to Disclose

Kyung Soo Lee, Abstract Co-Author: Nothing to Disclose

Ha Young Kim MD, Presenter: Nothing to Disclose

Myung Jin Chung MD, Abstract Co-Author: Nothing to Disclose

Tae Sung Kim, Abstract Co-Author: Nothing to Disclose

To evaluate the feasibility of high-field lung MR imaging (MRI) for the assessment of idiopathic interstitial pneumonia (IIP) disease activity using a T2W single shot turbo spin-echo (TSE) sequence and a dynamic enhancement study.

Our prospective study included 20 patients (M: F = 7:13, mean; 57.8 years, range; 43-70) with an IIP who underwent lung MRI at 3T MR unit and subsequent surgical biopsy. A total of 47 biopsy specimens were classified into two groups on pathology; active inflammations (n = 13) and fibrosis (n = 33). After obtaining T2W single-shot TSE of the thorax, dynamic MR was performed by using T1W 3D turbo filed echo (TFE) sequence (image series covering the whole thorax, at 1, 3, 5, and 10 minutes) after IV injection of contrast medium. For qualitative analysis, enhancement pattern was visually classified into three categories by reviewing dynamic MR subtraction images i.e., early enhancement and washout, delayed persistent enhancement, and little enhancement pattern. Quantitatively, the signal intensity-time curves were analyzed focusing on maximum peak enhancement, slope of enhancement and washout. MR signal changes observed on dynamic MR and on T2W TSE images were compared between active inflammation and fibrosis regions with Fisher’s exact test or student t-test.

The 20 patients had usual interstitial pneumonia (n = 9); nonspecific interstitial pneumonia group I (n = 4), group II (n = 2), and group III (n = 2); chronic hypersensitivity pneumonitis (n =1); cryptogenic organizing pneumonia (n = 1); and desquamative interstitial pneumonia (n =1). Active inflammation segments showed high signal intensity on T2W TSE (85%, 11/13, p < 0.001); and early enhancement pattern (92%, 12/13, p < 0.001) on enhanced subtraction images, which were corroborated with a faster slope (p < 0.001) and a more significant washout (p = 0.020) on quantitative analyses. Maximum peak was higher in active disease, but not statistically significant (p = 0.102).

T2W single-shot TSE images and multiphase dynamic enhancement study using fast imaging technique at 3T MR unit proved to be useful for assessing disease activity in IIPs.

Assessent of disease activity in IIPs

Yi, C, Lee, K, Kim, H, Chung, M, Kim, T, Three Tesla MRI in Idiopathic Interstitial Pneumonias: Usefulness at Qualitative and Quantitative Analyses of Disease Activity.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4434891.html