MDCT and MRI findings after antibiotic sub dosage in pneumonia

Abstract

To evaluate the usefulness of MDCT with perfusion and angiography, and MRI with DWI for distinguishing lung finding after sub-dosage antibiotics therapy in treatment of pneumonia. Sub therapeutic dosage is often in third world patients, in patients from rural parts and in low social environment. We enrolled 1425 patients with reported sub-dosage therapy and compare results with randomly selected 1425 patients with proper treatment who underwent MDCT and magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI). There were 824 (57.83%) male and 601 (42.17%) female and the same number in compare group. Patients were 18 to 75 years old. Two thoracic radiologists evaluated the morphological features and quantitatively measured the net enhancement of the findings at CT. They also reviewed MR images including unenhanced T1- and T2-weighted images, and DWI images. Differences were significant. Inflammation without changes were find in 237 patients with sub-dosage vs 17 with proper therapy, differences were detect by showing signal suppression on high-b-value DW images or high apparent diffusion coefficient (ADC) values of more than 2.4×10-3 mm2/s (P<0.001) between them. Abscess was find in 17 vs 1, ADC values of more than 1.7×10-3 mm2/s (P<0.001) between. Chronical bronchitis was find in 314 vs 24, ADC values of more than 0.7×10-3 mm2/s (P<0.001) with perfusion difference. Late complications (granuloma, scars, alveolar destruction, and pleura invasion) were find in 428 vs 36, ADC values of more than 3.1×10-3 mm2/s (P<0.001) and neoplasm were find in 28 vs 7, ADC values of more than 1.7×10-3 mm2/s (P<0.001). Distinguishing and determining of sub-dosage findings is important for proper medical treatment.