title: Pulmonary fibrosis: tissue characterization using late-enhanced MRI compared with unenhanced anatomic high-resolution CT.
abstract: OBJECTIVE
  We aimed to prospectively evaluate anatomic chest computed tomography (CT) with tissue characterization late gadolinium-enhanced magnetic resonance imaging (MRI) in the evaluation of pulmonary fibrosis (PF).
  
  
  METHODS
  Twenty patients with idiopathic pulmonary fibrosis (IPF) and twelve control patients underwent late-enhanced MRI and high-resolution CT. Tissue characterization of PF was depicted using a segmented inversion-recovery turbo low-angle shot MRI sequence. Pulmonary arterial blood pool nulling was achieved by nulling main pulmonary artery signal. Images were read in random order by a blinded reader for presence and extent of overall PF (reticulation and honeycombing) at five anatomic levels. Overall extent of IPF was estimated to the nearest 5% as well as an evaluation of the ratios of IPF made up of reticulation and honeycombing. Overall grade of severity was dependent on the extent of reticulation and honeycombing.
  
  
  RESULTS
  No control patient exhibited contrast enhancement on lung late-enhanced MRI. All IPF patients were identified with late-enhanced MRI. Mean signal intensity of the late-enhanced fibrotic lung was 31.8±10.6 vs. 10.5±1.6 for normal lung regions, P < 0.001, resulting in a percent elevation in signal intensity from PF of 204.8%±90.6 compared with the signal intensity of normal lung. The mean contrast-to-noise ratio was 22.8±10.7. Late-enhanced MRI correlated significantly with chest CT for the extent of PF (R=0.78, P = 0.001) but not for reticulation, honeycombing, or coarseness of reticulation or honeycombing.
  
  
  CONCLUSIONS
  Tissue characterization of IPF is possible using inversion recovery sequence thoracic MRI.
authors.affiliation: Department of Radiology, St Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland. J.Dodd@st-vincents.ie.
authors.forename: Lisa P
authors.initials: LP
authors.lastname: Lavelle
authors.forename: Darragh
authors.initials: D
authors.lastname: Brady
authors.forename: Sinead
authors.initials: S
authors.lastname: McEvoy
authors.forename: David
authors.initials: D
authors.lastname: Murphy
authors.forename: Brian
authors.initials: B
authors.lastname: Gibney
authors.forename: Annika
authors.initials: A
authors.lastname: Gallagher
authors.forename: Marcus
authors.initials: M
authors.lastname: Butler
authors.forename: Fionnula
authors.initials: F
authors.lastname: Shortt
authors.forename: Marie
authors.initials: M
authors.lastname: McMullen
authors.forename: Aurelie
authors.initials: A
authors.lastname: Fabre
authors.forename: David A
authors.initials: DA
authors.lastname: Lynch
authors.forename: Michael P
authors.initials: MP
authors.lastname: Keane
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Dodd
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005682:Gadolinium / Q000378:metabolism*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging* / Q000378:metabolism; D011856:Radiographic Image Enhancement / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D005682:Gadolinium