Abstract

Background

More than 70% of human immunodeficiency virus (HIV)-positive children sustain respiratory diseases in their lifetime. Imaging plays an important role in establishing early and correct diagnosis.

Objective

To evaluate the diagnostic accuracy of 3-Tesla (T) thorax MRI in HIV-positive children, using chest CT as the gold standard.

Materials and methods

We included 25 children with confirmed HIV-positive status and pulmonary complaints who were referred for chest CT. All children had 3-T thorax MRI using T2-W turbo spin-echo sequence, steady-state free precession gradient echo sequence, T2-W turbo spin-echo MultiVane XD sequence, and T1-weighted modified Dixon sequences. We evaluated the images for various pulmonary and mediastinal findings and calculated the sensitivity and specificity of 3-T thoracic MRI.

Results

Sensitivity of 3-T MRI was 100% for detecting nodules >4 mm (95% confidence interval [CI] 66.3–100%), pleural effusion (CI 29.2–100%) and lymphadenopathy (CI 81.5–100%). It demonstrated a specificity of 100% for nodules >4 mm (CI 79.4–100%), pleural effusion (CI 84.6–100%) and lymphadenopathy (CI 59–100%). For consolidation/collapse, sensitivity and specificity were 93.8% (CI 69.8–99.8%) and 88.9% (CI 51.8–99.7%), respectively. The sensitivity and specificity for detecting bronchiectasis were 75% (CI 42.8–94.5%) and 100% (CI 75.3–100%), respectively, while for ground-glass opacity, sensitivity and specificity were 75% (CI 34.9–96.8%) and 94.1% (CI 71.3–99.9%), respectively. Nodules <4 mm were not well detected on MRI, with sensitivity of 35% (CI 15.4–59.2%).

Conclusion

Thoracic MRI at 3 T demonstrates a high sensitivity and specificity for detecting nodules >4 mm, effusion and lymphadenopathy in HIV-positive children.

中文翻译：

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3-T肺磁共振成像对人免疫缺陷病毒阳性儿童的诊断准确性

摘要

背景

超过70％的人类免疫缺陷病毒（HIV）阳性儿童一生中都患有呼吸道疾病。成像在建立早期和正确的诊断中起着重要的作用。

目的

为了评估3-Tesla（T）胸部MRI在HIV阳性儿童中的诊断准确性，使用胸部CT作为金标准。

材料和方法

我们纳入了25例确诊为HIV阳性且患有肺部疾病的儿童，他们被转诊接受了胸部CT检查。所有儿童均使用T2-W涡轮自旋回波序列，稳态自由进动梯度回波序列，T2-W涡轮自旋回波MultiVane XD序列和T1加权修饰的Dixon序列进行3-T胸部MRI。我们评估了各种肺部和纵隔发现的图像，并计算了3T胸腔MRI的敏感性和特异性。

结果

3-T MRI检测> 4 mm结节（95％置信区间[CI] 66.3–100％），胸腔积液（CI 29.2–100％）和淋巴结病（CI 81.5–100％）的敏感性为100％。对于结节> 4 mm（CI 79.4–100％），胸腔积液（CI 84.6–100％）和淋巴结病（CI 59–100％），其特异性为100％。对于合并/折叠，敏感性和特异性分别为93.8％（CI 69.8–99.8％）和88.9％（CI 51.8–99.7％）。检测支气管扩张的敏感性和特异性分别为75％（CI 42.8–94.5％）和100％（CI 75.3–100％），而对于毛玻璃样混浊，敏感性和特异性为75％（CI 34.9–96.8％）和94.1％（CI 71.3-99.9％）。MRI未能很好地检测到<4 mm的结节，敏感性为35％（CI 15.4–59.2％）。

结论

3 T时的胸部MRI显示出对HIV阳性儿童检出大于4毫米的结节，积液和淋巴结病的高灵敏度和特异性。