Kushaljit Singh Sodhi1, Pankaj Gupta2, Amit Shrivastav2, Akshay Kumar Saxena2, Joseph L Mathew3, Meenu Singh3, Ritesh Agarwal4. 1. Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh, India. Electronic address: sodhiks@gmail.com. 2. Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh, India. 3. Department of Paediatrics, PGIMER, Chandigarh, India. 4. Department of Pulmonary Medicine, PGIMER, Chandigarh, India.
Abstract
OBJECTIVE: To evaluate the diagnostic performance of 3 T lung magnetic resonance imaging (MRI) in children with allergic bronchopulmonary aspergillosis (ABPA). MATERIALS AND METHODS: This study protocol was approved by the institutional ethics committee. From October 2015 to January 2018, we prospectively evaluated twenty-seven consecutive children with ABPA. The diagnosis of ABPA was made on the ISHAM-ABPA working group criteria. High resolution computed tomography (HRCT) and 3 T MRI of the chest was performed on the same day. Bronchiectasis, consolidation, nodules, and mucus impaction were assessed in all segments. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MRI were calculated using HRCT findings as the reference standard. Interobserver agreement was calculated using the kappa statistic. RESULTS: The mean age of the patients was 9.89 years (range: 5-16 years). There were 20 males and 7 females. The sensitivity, specificity, PPV, and NPV for bronchiectasis was 68%, 100%, 100% and 71.43% respectively. The sensitivity, specificity, PPV, and NPV for consolidation was 80%, 100%, 100% and 96% respectively. For detection of nodules, the sensitivity, specificity, PPV, and NPV was 75%, 100%, 100% and 88.46% respectively. There was 100% sensitivity, specificity, PPV and NPV for mucus impaction. There was a high degree of interobserver agreement for MRI findings (k = 0.9-1) as well as agreement (k = 0.7-1) between CT and MRI for all the four findings. CONCLUSION: With the currently available routine MR sequences, MRI demonstrates high specificity but less sensitivity and negative predictive value to HRCT scan in children with ABPA. Newer MR sequences need to be explored and validated to enhance the potential of lung MRI in ABPA.
OBJECTIVE: To evaluate the diagnostic performance of 3 T lung magnetic resonance imaging (MRI) in children with allergic bronchopulmonary aspergillosis (ABPA). MATERIALS AND METHODS: This study protocol was approved by the institutional ethics committee. From October 2015 to January 2018, we prospectively evaluated twenty-seven consecutive children with ABPA. The diagnosis of ABPA was made on the ISHAM-ABPA working group criteria. High resolution computed tomography (HRCT) and 3 T MRI of the chest was performed on the same day. Bronchiectasis, consolidation, nodules, and mucus impaction were assessed in all segments. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MRI were calculated using HRCT findings as the reference standard. Interobserver agreement was calculated using the kappa statistic. RESULTS: The mean age of the patients was 9.89 years (range: 5-16 years). There were 20 males and 7 females. The sensitivity, specificity, PPV, and NPV for bronchiectasis was 68%, 100%, 100% and 71.43% respectively. The sensitivity, specificity, PPV, and NPV for consolidation was 80%, 100%, 100% and 96% respectively. For detection of nodules, the sensitivity, specificity, PPV, and NPV was 75%, 100%, 100% and 88.46% respectively. There was 100% sensitivity, specificity, PPV and NPV for mucus impaction. There was a high degree of interobserver agreement for MRI findings (k = 0.9-1) as well as agreement (k = 0.7-1) between CT and MRI for all the four findings. CONCLUSION: With the currently available routine MR sequences, MRI demonstrates high specificity but less sensitivity and negative predictive value to HRCT scan in children with ABPA. Newer MR sequences need to be explored and validated to enhance the potential of lung MRI in ABPA.
Authors: Ritesh Agarwal; Inderpaul S Sehgal; Sahajal Dhooria; Valliappan Muthu; Kuruswamy T Prasad; Amanjit Bal; Ashutosh N Aggarwal; Arunaloke Chakrabarti Journal: Indian J Med Res Date: 2020-06 Impact factor: 2.375