Federica Volpi, Roberto Castellana, Beatrice Vivaldi, Roberta Pancani, Federico Dente, Giacomo De Nicola, Laura Carrozzi, Annalisa De Liperi, Emanuele Neri, Chiara Romei
In this preliminary pilot study, MRI appeared feasible for assessing morphological changes in adult patients with NCFB through a short imaging protocol. The qualitative DWI findings described provide preliminary observations that may contribute to generating hypotheses regarding pulmonary abnormalities but require validation in larger prospective studies with quantitative imaging and clinical correlation. However, further studies on larger and more heterogeneous cohorts are needed to improve the generalizability of the results, and adequate training is required for the assessment of thoracic MRI to ensure consistent and reproducible interpretation.
OBJECTIVES: To evaluate the feasibility of MRI in the assessment of adult patients with non-cystic fibrosis bronchiectasis (NCFB), in comparison with CT, in a retrospective pilot cohort. The potential contribution of diffusion-weighted imaging (DWI) for detecting pulmonary alterations was also investigated.
MATERIALS AND METHODS: In this single-center retrospective study, 21 patients with NCFB underwent unenhanced chest MRI. Two radiologists (A and B) independently scored MRI and CT images using the modified Helbich (Bhalla) score. DWI sequences were acquired with b values of 0, 400, and 800 s/mm2 and assessed visually and semi-quantitatively.
RESULTS: MRI and CT scores showed a positive correlation between the two readers (p < 0.05), with moderate-to-good inter-reader consistency (ICCMRI-A,B = 0.71; ICCCT-A,B = 0.77; p < 0.05). MRI and CT scores were significantly correlated for both readers, although within-reader MRI-CT agreement was higher for Reader A (ICCA-MRI,CT = 0.86; p < 0.05) and lower for Reader B (ICCB-MRI,CT = 0.31; p > 0.05). DWI and T2-weighted images revealed three hyperintense patterns: triangular-lamellar, pseudonodular-spot, and linear. As b-values increased, fewer findings were detectable, particularly for linear patterns, and signal intensity became more heterogeneous compared to the spinal cord.
CONCLUSIONS: In this preliminary pilot study, MRI appeared feasible for assessing morphological changes in adult patients with NCFB through a short imaging protocol. The qualitative DWI findings described provide preliminary observations that may contribute to generating hypotheses regarding pulmonary abnormalities but require validation in larger prospective studies with quantitative imaging and clinical correlation. However, further studies on larger and more heterogeneous cohorts are needed to improve the generalizability of the results, and adequate training is required for the assessment of thoracic MRI to ensure consistent and reproducible interpretation.