MDCT and MRI in bronchiectasis in older children and young adults-A
non-inferiority trial
Abstract
Purpose To compare and evaluate the usefulness of MRI with CT
as radiation free alternative To compare the reproducibility of CT and
MRI scores To compare MRI and CT scores with pulmonary function tests
(PFT) To evaluate the role of DWI in bronchiectasis. Methods In
this prospective study, 25 patients between 7-21 years of age with a
clinical/radiological diagnosis of bronchiectasis underwent MDCT (with
HRCT reconstruction) and MRI chest. MRI and CT scoring was performed
using modified Bhalla score -Helbich’s score by two independent
radiologists for all parameters. A final consensus score was recorded.
both in CT and MRI. The overall image quality of different MRI sequences
to identify the pathologies was also assessed. Appropriate statistical
tests were used for inter-observer agreements, and correlation amongst
CT and MRI; as well as CT, MRI and PFT. Results Strong
agreement (ICC 0.80-0.95) between CT and MRI was seen for extent and
severity of bronchiectasis, number of bullae, sacculation/abscess,
emphysema, collapse/ consolidation, mucus plugging, and mosaic
perfusion. Overall CT and MRI scores had perfect concordance (ICC
0.978). Statistically significant (p-value <0.01)
intraobserver and interobserver agreement for all CT and MRI score
parameters was seen. A strong negative correlation was seen between
total CT and MRI severity scores and FEV1, FVC, FEF 25-75%. DWI MR,
with an ADC cut-off of 1.62 x 10 -3 mm
3/sec had a sensitivity of 70% and specificity of
75% in detecting true mucus plugs. Conclusion MRI with DWI can
be considered in the diagnostic algorithm for assessment of lung changes
in bronchiectasis as a radiation-free non-invasive method of imaging in
children, especially in follow-up.