3-T MRI for differentiating inflammation- and fibrosis-predominant lesions of usual and nonspecific interstitial pneumonia: comparison study with pathologic correlation.
OBJECTIVE
The purpose of our study was to evaluate the utility of 3-T MRI of the lung for differentiating inflammation- and fibrosis-predominant lesions in the usual and nonspecific types of interstitial pneumonia.


METHODS
The subjects were 26 patients (10 men, 16 women; mean age, 57 +/- 9 [SD] years; 16 with nonspecific interstitial pneumonia; 10 with usual interstitial pneumonia) who underwent 3-T MRI of the lung and surgical biopsy. A total of 54 biopsy sites were classified histopathologically into two groups: inflammation predominant and fibrosis predominant. After a T2-weighted triple-inversion black blood turbo spin-echo (TSE) sequence, dynamic MRI was performed with a T1-weighted 3D turbo field-echo sequence (coronal images with 2.5-mm slice thickness) before and 1, 3, 5, and 10 minutes after i.v. contrast injection. The chi-square test was used to compare differences in signal intensity on T2-weighted triple-inversion black blood TSE MR images and visually assessed enhancement patterns at dynamic MRI for the inflammation- and fibrosis-predominant sites.


RESULTS
Inflammation-predominant specimens were obtained from 31% (17 of 54) of the biopsy sites. Inflammation-predominant biopsy sites had an early enhancement pattern (82%, 14 of 17 sites, p < 0.001) on dynamic studies and high signal intensity (53%, nine of 17 sites, p = 0.001) on T2-weighted triple-inversion black blood TSE images.


CONCLUSIONS
Multiphase dynamic enhancement studies with a turbo field-echo sequence and T2-weighted triple-inversion black blood TSE images on 3-T MRI appear to be useful for differentiating inflammation- and fibrosis-predominant lesions.
Yi
Chin A
CA
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-dong, Gangnam-gu, Seoul 135-710, Korea.
Lee
Kyung Soo
KS
Han
Joungho
J
Chung
Man Pyo
MP
Chung
Myung Jin
MJ
Shin
Kyung Min
KM
D001706:Biopsy; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000473:pathology