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Tesi etd-06232016-084428


Thesis type
Tesi di specializzazione (5 anni)
Author
CECCARELLI, ALESSIA
URN
etd-06232016-084428
Title
MRI evaluation of lung involvement on the basis of CT scans in systemic sclerosis
Struttura
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
RADIODIAGNOSTICA
Supervisors
relatore Prof. Caramella, Davide
relatore Prof. Neri, Emanuele
Parole chiave
  • MRI
  • LUNG
Data inizio appello
09/07/2016;
Consultabilità
Parziale
Data di rilascio
09/07/2019
Riassunto analitico
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.
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