Cross-sectional analysis of follow-up chest MRI and chest CT scans in patients previously affected by COVID-19

Abstract

Purpose The aim of the study was to prospectively evaluate the agreement between chest magnetic resonance imaging (MRI) and computed tomography (CT) and to assess the diagnostic performance of chest MRI relative to that of CT during the follow-up of patients recovered from coronavirus disease 2019. Materials and methods Fifty-two patients underwent both follow-up chest CT and MRI scans, evaluated for ground-glass opacities (GGOs), consolidation, interlobular septal thickening, fibrosis, pleural indentation, vessel enlargement, bronchiolar ectasia, and changes compared to prior CT scans. DWI/ADC was evaluated for signal abnormalities suspicious for inflammation. Agreement between CT and MRI was assessed with Cohen’s k and weighted k. Measures of diagnostic accuracy of MRI were calculated. Results The agreement between CT and MRI was almost perfect for consolidation (k = 1.00) and change from prior CT (k = 0.857); substantial for predominant pattern (k = 0.764) and interlobular septal thickening (k = 0.734); and poor for GGOs (k = 0.339), fibrosis (k = 0.224), pleural indentation (k = 0.231), and vessel enlargement (k = 0.339). Meanwhile, the sensitivity of MRI was high for GGOs (1.00), interlobular septal thickening (1.00), and consolidation (1.00) but poor for fibrotic changes (0.18), pleural indentation (0.23), and vessel enlargement (0.50) and the specificity was overall high. DWI was positive in 46.0% of cases. Conclusions The agreement between MRI and CT was overall good. MRI was very sensitive for GGOs, consolidation and interlobular septal thickening and overall specific for most findings. DWI could be a reputable imaging biomarker of inflammatory activity.

Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center

“…Data from these countries have proven the benefit of a booster dose in reducing symptomatic infection and offering a significant decrease in critical outcomes [ 49 , 50 , 51 , 52 , 53 , 54 ]. Moreover, the protection level offered by previous SARS-CoV-2 infection, both in terms of infection and disease severity and, therefore, of outcome, is still unclear [ 55 , 56 , 57 , 58 , 59 , 60 , 61 ]. In this scenario, the main essential element leading to the evolution of SARS-CoV-2 infection is the interaction with the host’s immune system.…”

Role of MRI in the Evaluation of Pulmonary Sequel Following COVID-19 Acute Respiratory Distress Syndrome (ARDS)

“…There was 100% sensitivity and 100% specificity for detection of GGOs, septal thickening/reticulations, and pleural thickening on MRI chest with a perfect agreement ( k =1) between the CT and MRI. However, a prospective study from Italy on post-COVID subjects after discharge reported more GGOs and interstitial thickening on MRI than CT with the reported frequency of 94.2% Vs. 76.9%, and 86.5% Vs. 78.8%, for MRI chest and CT chest, respectively ( 13 ). The sensitivity and specificity for GGOs on the MRI chest were 100% (95% CI: 0.91–1.00) and 25% (95% CI: 0.05–0.57), respectively.…”

“…TRUFI could detect only 75% of interstitial thickening and 80% GGOs. Pecoraro et al reported false-positive results for GGOs in 9 subjects on MRI chest, and the authors claimed the superior role of MRI with its ability to discriminate the GGOs by quantifying the proton density of alveolar contents ( 13 ). Nevertheless, CT has a high spatial resolution as compared to MRI ( 20 ), and no other studies comparing CT and MRI chest imaging reported higher detection of GGOs on MRI than CT. Rana et al reported false-positive detection of GGOs on T2-W TSE, T2-W MultiVane XD and T1W mDixon sequences in one child; and on SSFP sequence in two subjects ( 21 ).…”

“…Early scheduling of follow-up CT and MRI chest (∼11 days following remission (RT-PCR negative), IQR: 11.25–23 days) by Pecoraro and colleagues may be another reason for the low detection rate of subpleural multicystic changes. Moreover, Percoraro et al mentioned in their study that non-addition of 3D T1 sequences into their acquisition protocol might have resulted in a poor agreement between CT and MRI findings ( 13 ). Nevertheless, we could detect bronchial dilatation in 14/16 of our subjects on T1 VIBE and T2 BLADE sequences.…”

“…Magnetic resonance imaging (MRI) chest can be a good alternative imaging modality to CT chest for follow-up of the post-COVID-19 patients, as it doesn't impart ionizing radiation ( 10 , 11 , 12 ). Several authors have studied the diagnostic accuracy of MRI chest, and lately, few studies have shown that the detection rate of MRI chest is comparable to that of CT chest in acute COVID-19 pneumonia, and other chest conditions ( 10 , 11 , 13 , 14 ). We evaluated the diagnostic performance of 1.5T MRI chest done at 6 weeks of discharge in patients recovered from COVID-19 acute respiratory distress syndrome (ARDS); taking CT chest as a reference standard.…”