Objectives

To optimize lung protocols of 3.0T magnetic resonance imaging(MRI) for evaluation of pulmonary tuberculosis(TB) in the clinical routine.

Methods

42 patients who were diagnosed as pulmonary tuberculosis underwent CT and 3.0T MRI respectively. MRI lung protocols including the free-breathing T1WI StarVIBE, the multiple breath-hold VIBE, T2WI fBLADE and 3D SPACE were choosed and compared with image quality. The evaluation of image quality include SNR(signal to noise ratio), CNR(contrast to noise ratio) and 5-points scoring scale. 5-pionts scoring scale was evaluated by two radiologists and inter-observers agreement was calculated by cohen’s kappa(k). The SNR, CNR and 5-points scoring scale were compared using a two-tailed pared t-test. The detection rates and imaging findings were compared between CT and MRI. The detection rate of pulmonary abnormality was evaluated by Pearson’s Chi-square test.All analysis were evaluated by SPSS(version 19;IBM,Armonk,NY).

Results

Inter-observers showed moderate agreement on 5-points scoring scale. T1WI free-breathing StarVIBE and multiple breath-hold VIBE performed as well with rare artifacts(P＞0.05).T2WI fBLADE had significantly less artifacts than 3D SAPCE(P＜0.05). T1WI free-breathing StarVIBE had better SNR(P＜0.05)and identical CNR comparing with multiple breath-hold VIBE(P＞0.05). T2WI fBLADE had statistically higher SNR(P＜0.05) but inferior CNR comparing with 3D SPACE(P＞0.05). MRI performed as good as CT in detecting most of pulmonary abnormality, with overall sensitivity of 51.29%, 90.62%, 100% for non-calcified nodules of size＜5mm, 5-10mm, ≥10mm, 91.07% for calcified nodules and 78.57% for tree-in-bud sign. MRI has more advantages to show caseous necrosis, liquefaction, necrosis within cavity, alternations of lymph nodes and pleura.

Conclusions

T1WI free-breathing StarVIBE and T2WI fBLADE with satisfied image quality is feasible for lung imaging especially for patients who have poor breath and wide range of lesios. Radiation-free MRI is an alternative tool for pulmonary TB imaging, especially for children, the elderly,the pregnant and patients who need long-term follow-up.

Acknowledgements

No acknowledgement found.

References

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