Diffusion weighted imaging in cystic fibrosis disease: beyond morphological imaging.

Autor: Ciet P; Department of Radiology, Erasmus Medical Center, Rotterdam, Netherlands.; Department of Paediatrics, Respiratory Medicine and Allergology, Erasmus Medical Center - Sophia Children's Hospital, P.O. Box 2060, Wytemaweg 80, Rotterdam, 3000 CB, Zuid-Holland, Netherlands.; Department of Radiology, Ca' Foncello - General Hospital, Piazzale Ospedale, 1, 31100, Treviso, Italy., Serra G; Department of Radiology, University of Rome 'Sapienza', Rome, Italy., Andrinopoulou ER; Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands., Bertolo S; Department of Radiology, Ca' Foncello - General Hospital, Piazzale Ospedale, 1, 31100, Treviso, Italy., Ros M; Department of Pediatrics, Ca' Foncello Hospital, Treviso, Italy., Catalano C; Department of Radiology, University of Rome 'Sapienza', Rome, Italy., Colagrande S; Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence - Azienda Ospedaliero-Universitaria Careggi., Largo Brambilla 3, Florence, 50134, Italy., Tiddens HA; Department of Radiology, Erasmus Medical Center, Rotterdam, Netherlands.; Department of Paediatrics, Respiratory Medicine and Allergology, Erasmus Medical Center - Sophia Children's Hospital, P.O. Box 2060, Wytemaweg 80, Rotterdam, 3000 CB, Zuid-Holland, Netherlands., Morana G; Department of Radiology, Ca' Foncello - General Hospital, Piazzale Ospedale, 1, 31100, Treviso, Italy. gmorana@ulss.tv.it.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2016 Nov; Vol. 26 (11), pp. 3830-3839. Date of Electronic Publication: 2016 Feb 12.
DOI: 10.1007/s00330-016-4248-z
Abstrakt: Objectives: To explore the feasibility of diffusion-weighted imaging (DWI) to assess inflammatory lung changes in patients with Cystic Fibrosis (CF) METHODS: CF patients referred for their annual check-up had spirometry, chest-CT and MRI on the same day. MRI was performed in a 1.5 T scanner with BLADE and EPI-DWI sequences (b = 0-600 s/mm 2 ). End-inspiratory and end-expiratory scans were acquired in multi-row scanners. DWI was scored with an established semi-quantitative scoring system. DWI score was correlated to CT sub-scores for bronchiectasis (CF-CT BE ), mucus (CF-CT mucus ), total score (CF-CT total-score ), FEV 1 , and BMI. T-test was used to assess differences between patients with and without DWI-hotspots.
Results: Thirty-three CF patients were enrolled (mean 21 years, range 6-51, 19 female). 4 % (SD 2.6, range 1.5-12.9) of total CF-CT alterations presented DWI-hotspots. DWI-hotspots coincided with mucus plugging (60 %), consolidation (30 %) and bronchiectasis (10 %). DWI total-score correlated (all p < 0.0001) positively to CF-CT BE (r = 0.757), CF-CT mucus (r = 0.759) and CF-CT total-score (r = 0.79); and negatively to FEV 1 (r = 0.688). FEV 1 was significantly higher (p < 0.0001) in patients without DWI-hotspots.
Conclusions: DWI-hotspots strongly correlated with radiological and clinical parameters of lung disease severity. Future validation studies are needed to establish the exact nature of DWI-hotspots in CF patients.
Key Points: • DWI hotspots only partly overlapped structural abnormalities on morphological imaging • DWI strongly correlated with radiological and clinical indicators of CF-disease severity • Patients with more DWI hotspots had lower lung function values • Mucus score best predicted the presence of DWI-hotspots with restricted diffusion.
Databáze: MEDLINE
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