Pierluigi Ciet MD, Presenter: Nothing to Disclose

Piotr Alfred Wielopolski PhD, Abstract Co-Author: Nothing to Disclose

Sandra Lever, Abstract Co-Author: Nothing to Disclose

Els Van Der Wiel MD, Abstract Co-Author: Nothing to Disclose

Maarten H. Lequin MD, PhD, Abstract Co-Author: Nothing to Disclose

Harm Awm Tiddens MD, Abstract Co-Author: Nothing to Disclose

Giovanni Morana MD, Abstract Co-Author: Nothing to Disclose

CF leads to early and chronic Lung structural changes. CT is the most sensitive technique to monitor CF-lung disease. Bronchiectasis(BE) and air-trapping (AT) are the most clinical relevant information that can be obtained. Unfortunately CT exposes the patient to radiation, so restricting its use. MRI is an attractive alternative to CT, but it has poorer spatial resolution for BE and AT. Hypo-perfusion (HP) is a clinical relevant alternative for AT since it identifies areas that do not contribute to gas exchange. Aims: 1) To compare the distribution/volume of HP on CE-MRI to AT on MRI: 2) To correlate distribution/volume of HP and AT to spirometry parameters related to small airway disease (FEF25, FEF75 and FEV/FVC ratio).

In this 2 years cross-sectional study, 26 stable CF patients were enrolled (13 males, mean 14, range 8-18 yrs). MRI and spirometry were performed the same day as part of the routine annual examination. 1.5T MRI Scanner (Signa, General Electric). Protocol: SSFP 2D PD-w axial, coronal and sagittal (TR/TE/SL = 5.7/1.4/8mm ). GRE 3D-axial and -coronal (TR/TE/SL= 3/1/3mm; 0.1mmol/kg, Magnevist®Bayer). MRIs were anonymized and scored in random order with a semi-quantitative MRI-score. Descriptive statistics, T-test and Spearman correlation(r)were used.

2 patients were excluded for the analysis because of incomplete data. Mean AT score was 3.3 (range 0-8, SD 2,75). Mean HP score 4,4 (range 0-12, SD 3,94). Comparison of AT and HP scores showed that AT scores was decreased in 7 (29%), increased in 13 (51%) and unchanged in 17%(4). A significant relation was found between AT and HP (r=0.413; p=0.045). HP correlated negatively with FEF25 (r=-0.69; p=0.0001), FEF75(r=-0.46; p=0.02) and FEV/FVC(r=-0.51; p=0.01). AT correlated negatively with FEF75 (r=-0.48; p=0.016), but not with FEF25 and FEV/FVC. No significant differences were found between AT and HPs scores (p=0.17).

HP correlated better with spirometry parameters than AT did. Scores variations between MRI and CE-MRI suggest that AT zones do not always match with HP zones. CE-MRI is feasible and is potentially a clinical relevant parameter to monitor CF lung disease.

Hypo-perfusion defects are more sensitive indicator of small airways disease progression than Air Trapping. CEMRI should be included routinely in CF follow-up to determine its impact in CF care.

Ciet, P, Wielopolski, P, Lever, S, Van Der Wiel, E, Lequin, M, Tiddens, H, Morana, G, Comparison of Proton-MRI (MRI) and Contrast-enhanced MRI (CE-MRI) in Cystic Fibrosis (CF) to Detect Small Airways Disease.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11016724.html