title: Detection of Pulmonary tuberculosis: comparing MR imaging with HRCT.
abstract: BACKGROUND
  Computer 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.
  
  
  METHODS
  50 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.
  
  
  RESULTS
  Artifacts 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.
  
  
  CONCLUSIONS
  Technical 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.
authors.affiliation: Diagnostic Department, Radiology, "L, Spallanzani" National Institute for Infectious Diseases, Rome, Italy. radiologia@inmi.it
authors.forename: Elisa Busi
authors.initials: EB
authors.lastname: Rizzi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Schinina'
authors.forename: Massimo
authors.initials: M
authors.lastname: Cristofaro
authors.forename: Delia
authors.initials: D
authors.lastname: Goletti
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Palmieri
authors.forename: Nazario
authors.initials: N
authors.lastname: Bevilacqua
authors.forename: Francesco N
authors.initials: FN
authors.lastname: Lauria
authors.forename: Enrico
authors.initials: E
authors.lastname: Girardi
authors.forename: Corrado
authors.initials: C
authors.lastname: Bibbolino
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*