Accuracy and feasibility of dynamic contrast-enhanced 3D MR imaging in the assessment of lung perfusion: comparison with Tc-99 MAA perfusion scintigraphy.
OBJECTIVE
The aim of this study was to correlate findings of perfusion magnetic resonance imaging (MRI) and perfusion scintigraphy in cases where there was a suspicion of abnormal pulmonary vasculature, and to evaluate the usefulness of MRI in the detection of perfusion deficits of the lung.


METHODS
In all, 17 patients with suspected abnormality of the pulmonary vasculature underwent dynamic contrast-enhanced MRI. T1-weighted 3D fast-field echo pulse sequences were obtained (TR/TE 3.3/1.58 ms; flip angle 30 degrees; slice thickness 12 to 15 mm). The dynamic study was acquired in the coronal plane following administration of 0.1 mmol/kg gadopentetate dimeglumine. A total of 8 to 10 sections repeated 20 to 25 times at intervals of 1s were performed. Perfusion lung scintigraphy was carried out a maximum of 48 h before the MR examination in all cases. Two radiologists, who were blinded to the clinical data and results of other imaging methods, reviewed all coronal sections. MR perfusion images were independently assessed in terms of segmental or lobar perfusion defects in the 85 lobes of the 17 individuals, and the findings were compared with the results of scintigraphy.


RESULTS
Of the 17 patients, 8 were found to have pulmonary emboli, 2 chronic obstructive pulmonary disease with emphysema, 2 bullous emphysema, 2 Takayasu arteritis and 1 had a hypoplastic pulmonary artery. Pulmonary perfusion was completely normal in 2 cases. In 35 lobes, perfusion defects were detected using both methods, in 4 with MR alone and in 9 only with scintigraphy. There was good agreement between MRI and scintigraphy findings (kappa=0.695).


CONCLUSIONS
Pulmonary perfusion MRI is a new alternative to scintigraphy in the evaluation of pulmonary perfusion for various lung disorders. In addition, this technique allows measurement and quantification of pulmonary perfusion abnormalities.
Yilmaz
E
E
Department of Radiology, Dokuz Eylül University School of Medicine, 35340 Izmir, Turkey. yilmazdr@yahoo.com
Akkoclu
A
A
Degirmenci
B
B
Cooper
R A
RA
Sengun
B
B
Gulcu
A
A
Osma
E
E
Ucan
E S
ES
D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D005240:Feasibility Studies; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008168:Lung / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D011651:Pulmonary Artery / Q000002:abnormalities / Q000000981:diagnostic imaging; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology; D011655:Pulmonary Embolism / Q000175:diagnosis; D011656:Pulmonary Emphysema / Q000175:diagnosis / Q000503:physiopathology; D011859:Radiography; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013625:Takayasu Arteritis / Q000175:diagnosis / Q000503:physiopathology; D013668:Technetium Tc 99m Aggregated Albumin
D003287:Contrast Media; D013668:Technetium Tc 99m Aggregated Albumin; D019786:Gadolinium DTPA