• LUNG
• MRI

Objectives - The aim of this study was to assess resonance signal of lung fields, using Cardiac-MRI performed to detect myocardial involvement in patients affected by systemic sclerosis.
Materials and methods - Retrospectively we analyzed HRCT scans performed on 40 patients with a diagnosis of systemic sclerosis, who underwent a HRCT scan and MRI (Cardiac-MRI) the same day.
HRCT scans were scored by two radiologists on the basis of "Scleroderma lung study”, a semi-quantitative scoring to evaluate the four categories of parenchymal abnormality (pure Ground Glass Opacities, lung fibrosis including thickened reticular markings, bronchiectasis, bronchioloectasis and honeycombing ).
The MRI abnormalities were evaluated in comparison with HRCT observations utilized as reference standard.
A STIR and T1-weighted (before and after Gadolinium administration) sequences were performed; patient images were analyzed using a software (HIPPO SW), that allows to draw one or more regions of interest (ROI) manually and to obtain with a curve-fitting technique to estimate STIR and T1 values in the ROI; the ROI(s) were drawn in anatomical sections corresponding to normal lung parenchyma or scleroderma lung abnormalities as demonstrated by HRCT scan. STIR and T1 values so obtained were compared.
Results - With the patient in supine position, the posterior dependent areas presented higher signal than anterior non dependent areas. We obtained a significantly different signal between dependent areas and pathological interstitial pattern , using both STIR and T1-weighted pre and post-contrast sequences, whereas no significant signal difference between specific interstitial patterns (GG, RET and GG+/-RET) was demonstrated.
Conclusion - MRI with STIR and T1- weighted sequences, if performed to assess cardiac involvement, can be used as an alternative to HRCT to reduce radiation exposure, especially in young patients; it is amenable to detect lung interstitial involvement in Systemic sclerosis, but not to recognize specific interstitial pattern such as GG or GG and RET.