SARCOIDOSIS VALUE OF GADOLINIUM-ENHANCED MRI IN THE EVALUATION OF DISEASE ACTIVITY. EARLY REPORT

Sarcoidosis (S) is a not particularly common disease and its pathogenesis is not yet known. High doses of corticosteroids are effective only in the early stage of disease. Once fibrosis has developed, no effective therapy is known. The lack of an objective system for assessment to evaluate disease course and effectiveness of therapy is a major problem. We used Gadolinium-enhancement MRI (Ga-MRI) to evaluate disease activity; in fact we did think it might show a good correlation, because disruption of pulmonary capillary endothelium S-induced permits the extravasation of Ga into the interstitial and alveolar spaces. The study includes 10 consecutive patients who had parenchimal opacification on CT scan and a definitive diagnosis made on basis of transbronchial biopsy. Our study group consisted of 8 males and 2 females, aged from 42-67 ys, with clinical symptoms or radiographic findings which were present for >1 month. T1-weigheted-bold MRI study was obtained before and after iv injection of Ga.. we observed the presence of enhanced pulmonary lesions in 6 patients. All of these patients had active disease. Four patients had unhenanced lesions and two of these ones showed negative enhancement in presence of active disease. Pulmonary lesions were not enhanced in any patients with inactive disease. Results of statistical analysis were significant. Ga-MRI may prove to be a useful tool in assessing S. Now we are studying the fitting of this observations in sera flogosis markers in a larger group of patients