Abstract
BackgroundComputer Tomography (CT) is considered the gold standard for assessing the morphological changes of lung parenchyma. Although novel CT techniques have substantially decreased the radiation dose, radiation exposure is still high. Magnetic Resonance Imaging (MRI) has been established as a radiation- free alternative to CT for several lung diseases, but its role in infectious diseases still needs to be explored further. Therefore, the purpose of our study was to compare MRI with high resolution CT (HRCT) for assessing pulmonary tuberculosis.Methods50 patients with culture-proven pulmonary tuberculosis underwent chest HRCT as the standard of reference and were evaluated by MRI within 24 h after HRCT. Altogether we performed 60 CT and MRI examinations, because 10 patients were also examined by CT and MRI at follow- up. Pulmonary abnormalities, their characteristics, location and distribution were analyzed by two readers who were blinded to the HRCT results.ResultsArtifacts did not interfere with the diagnostic value of MRI. Both HRCT and MRI correctly diagnosed pulmonary tuberculosis and identified pulmonary abnormalities in all patients. There were no significant differences between the two techniques in terms of identifying the location and distribution of the lung lesions, though the higher resolution of MRI did allow for better identification of parenchymal dishomogeneity, caseosis, and pleural or nodal involvement.ConclusionTechnical developments and the refinement of pulse sequences have improved the quality and speed of MRI. Our data indicate that in terms of identifying lung lesions in non-AIDS patients with non- miliary pulmonary tuberculosis, MRI achieves diagnostic performances comparable to those obtained by HRCT but with better and more rapid identification of pulmonary tissue abnormalities due to the excellent contrast resolution.
Highlights
Computer Tomography (CT) is considered the gold standard for assessing the morphological changes of lung parenchyma
Our data indicate that in terms of identifying lung lesions in non-AIDS patients with non- miliary pulmonary tuberculosis, Magnetic Resonance Imaging (MRI) achieves diagnostic performances comparable to those obtained by high resolution CT (HRCT) but with better and more rapid identification of pulmonary tissue abnormalities due to the excellent contrast resolution
MRI plays a role in assessing lung parenchyma [1,3,4,5] and could be useful in diagnosing pneumonia, due to the exudative accumulation of water and cells occurring in the air space
Summary
Computer Tomography (CT) is considered the gold standard for assessing the morphological changes of lung parenchyma. Magnetic Resonance Imaging (MRI) has been established as a radiation- free alternative to CT for several lung diseases, but its role in infectious diseases still needs to be explored further. Major problems result from susceptibility artifacts caused by extensive air-tissue parenchymal interfaces and the lowproton density of normal parenchyma, both of which are factors that lead to low signal intensity of the normal lung. Proton density increases when lung tissue damage determines air space obliteration, reducing the susceptibility effects In these cases, MRI plays a role in assessing lung parenchyma [1,3,4,5] and could be useful in diagnosing pneumonia, due to the exudative accumulation of water and cells occurring in the air space
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