As pulmonary complications are life limiting in patients with cystic fibrosis (CF), repeated chest imaging [chest x-ray
, computed tomography (CT)] is needed for follow up. With the continuously rising life expectancy of CF patients, magnetic resonance imaging (MRI) as a radiation-free imaging modality might become more and more attractive. The goal of this study was to prospectively assess the value of MRI for evaluation of morphologic pulmonary CF-changes in comparison to established imaging modalities.
Materials and Methods:
Thirty-one CF patients (19 female, 12 male; mean age 16.7 years) with stable lung
disease were examined by MRI: HASTE, coronal/transversal (TR/TE/α/TA: infinite/28 ms/180°/18 s), multi-detector computed tomography (MDCT
) (30 patients): 120 kV, dose modulated mAs, and chest x-ray
(21 patients). Image evaluation: random order, 4 chest radiologists in consensus; chest x-ray
: modified Chrispin-Norman score; CT and MRI: modified Helbich score. The maximal attainable score for chest x-ray
was 34, for MRI and CT 25. Median scores, Pearson correlation coefficients, Bland-Altman plots, and concordance of MRI to CT on a lobar and segmental basis were calculated.
The median MRI and MDCT
scores were 13 (min 3, max 20) respectively 13.5 (min 0, max 20). The median chest x-ray
score was 14 (min 5, max 32). Pearson correlation coefficients: MRI/CT = 0.80, P
< 0.0001; MRI/chest x-ray
= 0.63, P
< 0.0018; chest x-ray
/CT = 0.75, P
< 0.0001. The median lobe related concordance was 80% for bronchiectasis, 77% for mucus plugging, 93%, for sacculation/abscesses, and 100% for collapse/consolidation.
Conclusions: Morphologic MRI
of the lung
in CF patients demonstrates comparable results to MDCT
and chest x-ray
. Because radiation exposure is an issue in CF patients, MRI might have the ability to be used as an appropriate alternative method for pulmonary imaging.