title: Lung magnetic resonance imaging with diffusion weighted imaging provides regional structural as well as functional information without radiation exposure in primary antibody deficiencies.
abstract: OBJECTIVE
  Primary antibody deficiency patients suffer from infectious and non-infectious pulmonary complications leading over time to chronic lung disease. The complexity of this pulmonary involvement poses significant challenge in differential diagnosis in patients with long life disease and increased radio sensitivity. We planned to verify the utility of chest Magnetic Resolution Imaging with Diffusion-Weighted Imaging as a radiation free technique.
  
  
  METHODS
  Prospective evaluation of 18 patients with Common Variable Immunodeficiency and X-linked Agammaglobulinemia. On the same day, patients underwent Magnetic Resonance Imaging with Diffusion Weighted Imaging sequences, High Resolution Computerized Tomography and Pulmonary Function Tests, including diffusing capacity factor for carbon monoxide. Images were scored using a modified version of the Bhalla scoring system.
  
  
  RESULTS
  Magnetic Resonance Imaging was non-inferior to High Resolution Computerized Tomography in the capacity to identify bronchial and parenchymal abnormalities. HRCT had a higher capacity to identify peripheral airways abnormalities, defined as an involvement of bronchial generation up to the fifth and distal (scores 2-3). Bronchial scores negatively related to pulmonary function tests. One third of consolidations and nodules had Diffusion Weighted Imaging restrictions associated with systemic granulomatous disease and systemic lymphadenopathy. Lung Magnetic Resolution Imaging detected an improvement of bronchial and parenchymal abnormalities, in recently diagnosed patients soon after starting Ig replacement.
  
  
  CONCLUSIONS
  Magnetic Resonance Imaging with Diffusion Weighted Imaging was a reliable technique to detect lung alterations in patients with Primary Antibody Deficiencies.
authors.affiliation: Department of Molecular Medicine, Sapienza University of Rome, Viale dell'Università 37, Rome, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Milito
authors.forename: Federica
authors.initials: F
authors.lastname: Pulvirenti
authors.forename: Goffredo
authors.initials: G
authors.lastname: Serra
authors.forename: Michele
authors.initials: M
authors.lastname: Valente
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Pesce
authors.forename: Guido
authors.initials: G
authors.lastname: Granata
authors.forename: Carlo
authors.initials: C
authors.lastname: Catalano
authors.forename: Francesco
authors.initials: F
authors.lastname: Fraioli
authors.forename: Isabella
authors.initials: I
authors.lastname: Quinti
mesh_terms: D000328:Adult; D000361:Agammaglobulinemia / Q000150:complications / Q000175:diagnosis*; D017074:Common Variable Immunodeficiency / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D040181:Genetic Diseases, X-Linked / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000209:etiology; D000069079:Radiation Exposure / Q000517:prevention & control; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000379:methods