title: Lung morphology assessment with balanced steady-state free precession MR imaging compared with CT.
abstract: OBJECTIVE
  To evaluate the utility of 1.5-T noncontrast magnetic resonance (MR) imaging of the lung parenchyma and to compare it with computed tomography (CT) in the assessment of interstitial lung disease and other morphologic lung abnormalities.
  
  
  METHODS
  Institutional review board approval was obtained for retrospective image analysis. A total of 236 patients who underwent MR imaging and CT as part of their assessment for suspected pulmonary hypertension were included in this study. Lung MR imaging was performed with a 1.5-T system as a stack of axial two-dimensional balanced steady-state free precession (bSSFP) acquisitions. Two radiologists independently evaluated CT and MR images for various morphologic abnormalities, such as pulmonary fibrosis, pleural and mediastinal disease, solid lesions, bronchial disease, and emphysema. Κ statistics were used to measure interobserver agreement.
  
  
  RESULTS
  Sensitivity and specificity of MR imaging in the identification of pulmonary fibrosis (n = 46) were 89% (95% confidence interval: 77%, 96%) and 91% (95% confidence interval: 76%, 98%), respectively, when compared with CT. In comparison to CT, MR imaging depicted 75% of ground-glass opacities. Nine of the 12 noncalcified nodules were identified on MR images. Lung nodules (75%, κ = 0.71) and effusions (100%, κ = 0.89) were also well visualized on MR images. MR imaging was however less effective in depicting emphysema (16%, κ = 0.60) and minor fibrosis (67%, κ = 0.79).
  
  
  CONCLUSIONS
  This study shows bSSFP MR imaging is inferior to CT in imaging parenchymal lung disease; however, this study does demonstrate for the first time a potential role for the bSSFP sequence as an alternative radiation-free noncontrast imaging modality for use in patients with pulmonary fibrosis.
authors.affiliation: University of Sheffield, C Floor, Royal Hallamshire Hospital, Sheffield, England. s.rajaram@sheffield.ac.uk
authors.forename: Smitha
authors.initials: S
authors.lastname: Rajaram
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Swift
authors.forename: David
authors.initials: D
authors.lastname: Capener
authors.forename: Adam
authors.initials: A
authors.lastname: Telfer
authors.forename: Christine
authors.initials: C
authors.lastname: Davies
authors.forename: Catherine
authors.initials: C
authors.lastname: Hill
authors.forename: Robin
authors.initials: R
authors.lastname: Condliffe
authors.forename: Charles
authors.initials: C
authors.lastname: Elliot
authors.forename: Judith
authors.initials: J
authors.lastname: Hurdman
authors.forename: David G
authors.initials: DG
authors.lastname: Kiely
authors.forename: Jim M
authors.initials: JM
authors.lastname: Wild
mesh_terms: D003287:Contrast Media; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000000981:diagnostic imaging; D007091:Image Processing, Computer-Assisted; D007472:Iohexol / Q000031:analogs & derivatives; D008171:Lung Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide