title: Comparison between magnetic resonance imaging and computed tomography of the lung in patients with cystic fibrosis with regard to clinical, laboratory, and pulmonary functional parameters.
abstract: OBJECTIVE
  To evaluate whether magnetic resonance imaging (MRI) is effective as computed tomography (CT) in determining morphologic and functional pulmonary changes in patients with cystic fibrosis (CF) in association with multiple clinical parameters.
  
  
  METHODS
  Institutional review board approval and patient written informed consent were obtained. In this prospective study, 30 patients with CF (17 men and 13 women; mean (SD) age, 30.2 (9.2) years; range, 19-52 years) were included. Chest CT was acquired by unenhanced low-dose technique for clinical purposes. Lung MRI (1.5 T) comprised T2- and T1-weighted sequences before and after the application of 0.1-mmol·kg gadobutrol, also considering lung perfusion imaging. All CT and MR images were visually evaluated by using 2 different scoring systems: the modified Helbich and the Eichinger scores. Signal intensity of the peribronchial walls and detected mucus on T2-weighted images as well as signal enhancement of the peribronchial walls on contrast-enhanced T1-weighted sequences were additionally assessed on MRI. For the clinical evaluation, the pulmonary exacerbation rate, laboratory, and pulmonary functional parameters were determined.
  
  
  RESULTS
  The overall modified Helbich CT score had a mean (SD) of 15.3 (4.8) (range, 3-21) and median of 16.0 (interquartile range [IQR], 6.3). The overall modified Helbich MR score showed slightly, not significantly, lower values (Wilcoxon rank sum test and Student t test; P > 0.05): mean (SD) of 14.3 (4.7) (range, 3-20) and median of 15.0 (IQR, 7.3). Without assessment of perfusion, the overall Eichinger score resulted in the following values for CT vs MR examinations: mean (SD), 20.3 (7.2) (range, 4-31); and median, 21.0 (IQR, 9.5) vs mean (SD), 19.5 (7.1) (range, 4-33); and median, 20.0 (IQR, 9.0). All differences between CT and MR examinations were not significant (Wilcoxon rank sum tests and Student t tests; P > 0.05). In general, the correlations of the CT scores (overall and different imaging parameters) to the clinical parameters were slightly higher compared to the MRI scores. However, if all additional MRI parameters were integrated into the scoring systems, the correlations reached the values of the CT scores. The overall image quality was significantly higher for the CT examinations compared to the MRI sequences.
  
  
  CONCLUSIONS
  One major diagnostic benefit of lung MRI in CF is the possible acquisition of several different morphologic and functional imaging features without the use of any radiation exposure. Lung MRI shows reliable associations with CT and clinical parameters, which suggests its implementation in CF for routine diagnosis, which would be particularly important in follow-up imaging over the long term.
authors.affiliation: From the *Department of Radiology, Charité University Medicine Berlin, Campus Virchow Clinic, Berlin; †Institute of Diagnostic and Interventional Radiology, SRH Clinic Gera, Gera; ‡Division of Pulmonology and Immunology, Department of Pediatrics, Charité University Medicine Berlin, Campus Virchow Clinic, Berlin; §Department of Internal Medicine III, and ∥Institute of Diagnostic and Interventional Radiology, Department of Pediatric Radiology, Friedrich-Schiller-University, Jena University Hospital, Jena, Germany.
authors.forename: Diane M
authors.initials: DM
authors.lastname: Renz
authors.forename: Oriane
authors.initials: O
authors.lastname: Scholz
authors.forename: Joachim
authors.initials: J
authors.lastname: Böttcher
authors.forename: Martin H
authors.initials: MH
authors.lastname: Maurer
authors.forename: Timm
authors.initials: T
authors.lastname: Denecke
authors.forename: Carsten
authors.initials: C
authors.lastname: Schwarz
authors.forename: Alexander
authors.initials: A
authors.lastname: Pfeil
authors.forename: Florian
authors.initials: F
authors.lastname: Streitparth
authors.forename: Alexander
authors.initials: A
authors.lastname: Huppertz
authors.forename: Anne
authors.initials: A
authors.lastname: Mehl
authors.forename: Alexander
authors.initials: A
authors.lastname: Poellinger
authors.forename: Doris
authors.initials: D
authors.lastname: Staab
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Mentzel
mesh_terms: D000328:Adult; D003287:Contrast Media; D003550:Cystic Fibrosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D011446:Prospective Studies; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol