Delayed contrast dynamics as marker of regional impairment in pulmonary fibrosis using 5D MRI - a pilot study
Objective:To analyse delayed contrast dynamics of fibrotic lesions in interstitial lung disease (ILD) using five dimensional (5D) MRI and to correlate contrast dynamics with disease severity.Methods:20 patients (mean age: 71 years; M:F, 13:7), with chronic fibrosing ILD: n = 12 idiopathic pulmonary...
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| Main Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
[2020]
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| In: |
British journal of radiology
Year: 2020, Volume: 93, Issue: 1113 |
| ISSN: | 1748-880X |
| DOI: | 10.1259/bjr.20190121 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1259/bjr.20190121 Verlag, lizenzpflichtig, Volltext: https://www.birpublications.org/doi/10.1259/bjr.20190121 
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| Author Notes: | Maria TA Buzan, Andreas Wetscherek, Christopher M Rank, Michael Kreuter, Claus Peter Heussel, Marc Kachelrieß, Julien Dinkel |
| Summary: | Objective:To analyse delayed contrast dynamics of fibrotic lesions in interstitial lung disease (ILD) using five dimensional (5D) MRI and to correlate contrast dynamics with disease severity.Methods:20 patients (mean age: 71 years; M:F, 13:7), with chronic fibrosing ILD: n = 12 idiopathic pulmonary fibrosis (IPF) and n = 8 non-IPF, underwent thin-section multislice CT as part of the standard diagnostic workup and additionally MRI of the lung. 2 min after contrast injection, a radial gradient echo sequence with golden-angle spacing was acquired during 5 min of free-breathing, followed by 5D image reconstruction. Disease was categorized as severe or non-severe according to CT morphological regional severity. For each patient, 10 lesions were analysed.Results:IPF lesions showed later peak enhancement compared to non-IPF (severe: p = 0.01, non-severe: p = 0.003). Severe lesions showed later peak enhancement compared to non-severe lesions, in non-IPF (p = 0.04), but not in IPF (p = 0.35). There was a tendency towards higher accumulation and washout rates in IPF compared to non-IPF in non-severe disease. Severe lesions had lower washout rate than non-severe ones in both IPF (p = 0.003) and non-IPF (p = 0.005). Continuous contrast agent accumulation, without washout, was found only in IPF lesions.Conclusions:Contrast agent dynamics are influenced by type and severity of pulmonary fibrosis, which might enable a more thorough characterisation of disease burden. The regional impairment is of particular interest in the context of antifibrotic treatments and was characterised using a non-invasive, non-irradiating, free-breathing method.Advances in knowledge:Delayed contrast enhancement patterns allow the assessment of regional lung impairment which could represent different disease stages or phenotypes in ILD. |
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| Item Description: | Gesehen am 25.09.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1748-880X |
| DOI: | 10.1259/bjr.20190121 |