MRI Evaluation of Pulmonary Lesions and Lung Tissue Changes Induced by Tuberculosis.

OBJECTIVE: To evaluate the utility of magnetic resonance imaging (MRI) with an advanced motion correction technique in characterizing lung tissue changes and lesions induced by pulmonary tuberculosis (TB).

SUBJECTS AND METHODS: Sixty-three subjects with computer tomography (CT) features of pulmonary TB received lung MRI. All subjects with pulmonary TB were confirmed by Acid-Fast Bacillus (AFB) Testing or detection of mycobacterium TB. T2-weighted turbo spin echo (TSE) sequence with the MultiVane motion correction technique was used to imaging lung. Routine lung CT images were obtained as references. MRI and CT images were reviewed by multiple readers independently. The performance of MRI in depicting abnormalities induced by pulmonary TB and their morphological changes were evaluated and compared with CT.

RESULTS: Lung MRI found pulmonary abnormalities in all 63 TB subjects with satisfactory quality. With MultiVane implemented T2 weighted TSE sequence to reduce the motion correction effect, MRI had excellent agreement with CT in detecting abnormal imaging features of pulmonary TB (к=0.88-1, P <0.001), such as tree-in-bud sign, ground glass opacity, consolidation, mass, and cavitation. MRI was advantageous in identifying caseation or liquefactive necrosis based on inhomogeneous signal distribution within consolidation and mild pleural effusion. The optimized lung MRI was comparable to CT in detecting non-calcified nodules (к=0.90) with overall sensitivity of 50.0, 91.1 and 100% for nodules of size < 5mm, 5-10mm and > 10mm, respectively. However, MRI was less effective in identifying lesions with calcification.

CONCLUSION: The clinical implementation of an optimized MRI protocol with the MultiVane motion correction technique for imaging pulmonary TB is feasible. Lung MRI without ionized radiation is a promising alternative to the clinical standard CT, especially for pregnant women, children, adolescents, and patients requiring short-term and repeated follow-up observations.