Study objective: To determine the value of
gadolinium-enhanced MRI in the assessment of disease activity in
chronic infiltrative lung diseases (CILDs).
Materials and Methods: Twenty-five
consecutive patients with CILD 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 open 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).
Gadolinium-enhanced MRI may prove to be a useful tool in assessing
disease activity in CILDs.