Chronic infiltrative lung diseases - Value of gadolinium- enhanced MRI in the evaluation of disease activity - Early report

Study objective: To determine the value of gadolinium-enhanced MRI in the assessment of disease activity in chronic infiltrative lung diseases (CILDs). Design: Retrospective study, Setting: University hospital, Materials and Methods:: Twenty-five consecutive patients with GILD were studied. The following diseases were diagnosed: sarcoidosis (n = 10), bronchiolitis obliterans organizing pneumonia (n = 3), usual interstitial pneumonia (n = 4), radiation pneumonia (n = 2), desquamative interstitial pneumonia (n = 1), rheumatoid lung (n = 1), vasculitis (n = 1), alveolar proteinosis (n = 1), bronchioloalveolar carcinoma (n = 1), and chronic eosinophilic pneumonia (n = 1). In each patient, the disease activity was assessed by one or more of the following studies: BAL (n = 18), gallium-radioisotope lung scanning(n = 6), serum angiotensin-converting enzyme assay (n = 10), and ol,en lung biopsy (n = 4), T1-weighted breath-hold MRI studies were obtained before and after IV injection of gadolinium. The MRI examinations were analyzed to assess the presence or absence of lesional enhancement. Results: The presence of enhanced pulmonary lesions was seen in 14 patients, All of these patients had active disease. Of the 17 patients with active disease, 14 had enhanced lesions, and 3 had unenhanced lesions. Pulmonary lesions were not enhanced in any patients with inactive disease, The difference was statistically significant (Fisher Exact Test, p < 0.05), Conclusion: Gadolinium-enhanced MRI may prove to be a useful tool in assessing disease activity in CILDs