Nino Kiria MD, Presenter: Nothing to Disclose

Jutta Hammermann, Abstract Co-Author: Nothing to Disclose

Bernhard Schulte-Hubbert, Abstract Co-Author: Nothing to Disclose

Michael Laniado MD, Abstract Co-Author: Nothing to Disclose

Nasreddin Abolmaali MD, Abstract Co-Author: Nothing to Disclose

The aim of this study was to prospectively assess the value of magnetic resonance imaging (MRI) for evaluation of morphologic pulmonary changes in cystic fibrosis (CF) patients with positive microbiology.

35 CF patients (11-39 years, mean age 25) with bronchoscopically proven colonization with different typical bacteria, who were admitted to the hospital for their annual follow-up and elective antibiosis or with an acute exacerbation, received MRI of the lung. MRI was performed in at 1,5T using body matrix coils. Examination protocol included transversal and axial T2-weighted single shot (HASTE) and axial T1-weighted fatsat gradient echo (VIBE) before and after contrast media (CM) application in inspirational breath-holding. Additionally, coronal keyhole perfusion MRI (TWIST) during CM-application in inspiration and navigator triggered free breathing T2-weighted turbo spin echo (TSE) imaging was acquired. Images were analyzed by two radiologists in consensus. To detect sensitivity of different sequences in depicting acute lung changes, we scored each sequence with 0 to 2 points (0 – no, 1 – moderate, 2 – good detectability).

In 35 patients with positive microbiology, 60 % (21 patients) showed acute pulmonary changes as infiltrates or consolidations in MR imaging. In all patients, chronic changes of the lung parenchyma (e.g. bronchiectases) were seen and modified Bhalla scoring was possible. The quantification (mean±standard deviation) of visualization of acute pulmonary changes were 1.8±0.4 in VIBE-CM application, 1.7±0.5 in HASTE, 1.5±0.5 in T2 TSE and 1.4±0.6 in VIBE.

Acute pulmonary changes in CF-patients with positive microbiology can be detected by dedicated MRI. HASTE imaging showed best results and is not dependent from CM-application. Acute exacerbations and annual follow-up can be performed fast and without ionizing irradiation. With the increasing life expectancy of the CF patients MRI gains importance in monitoring of disease progression and acquiring therapy results.

In 60% of our hospitalized CF-patients with positive microbiology, we were able to detect signs of acute pulmonary inflammation by dedicated pulmonary MRI.

Kiria, N, Hammermann, J, Schulte-Hubbert, B, Laniado, M, Abolmaali, N, Acute Pulmonary Inflammations in Hospitalized Cystic Fibrosis Patients as Detected by MRI.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12031930.html