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MR Imaging of Pneumonia in Immunocompromised Patients

Comparison with Helical CT

¹ Department of Radiology, University of Bonn, Bonn, Germany.
² Philips Medical Systems, Eindhoven, The Netherlands.
³ Department of Internal Medicine, University of Bonn, 53127 Bonn, Germany.
⁴ Department of Pathology, University of Bonn, 53127 Bonn, Germany.

OBJECTIVE. A T2-weighted turbo spin-echo sequence was compared with CT in immunocompromised patients with opportunistic pneumonia.

SUBJECTS AND METHODS. Sixteen patients with pneumonia shown on helical CT were examined using MR imaging within 2 days. MR examinations were performed on a 1.5-T system with a transversal T2-weighted ultrashort turbo spin-echo sequence using expiratory gating and diastolic triggering. Two radiologists reviewed the MR and CT images independently. The number, localization, and morphology of lesions were noted. MR image quality was rated using a 4-point scale.

RESULTS. The results of the CT and MR examinations concerning the number and morphology of pulmonary lesions caused by pneumonia were identical in 75% of the patients (n = 12). MR imaging was able to depict all typical features of pneumonia including different stages of parenchymal infiltration (ground-glass versus consolidation). MR imaging depicted early necrotizing pneumonia not shown on contrast-enhanced CT in 25% of the patients (n = 4); 82% of the MR examinations were rated as excellent (1 point) or good (2 points).

CONCLUSION. T2-weighted turbo spin-echo imaging is able to depict characteristic features of pneumonia and shows excellent results compared with CT. This MR technique offers advantages in patients with pneumonia because of its higher sensitivity for necrotizing pneumonia.

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