High-performance low field MRI enables visualization of persistent pulmonary damage after COVID-19

Abstract

The outbreak of coronavirus disease 2019 (COVID-19) with the origin of the spread assumed to be located in Wuhan, China, began in December 2019, and is continuing until now. With the COVID-19 pandemic showing a progressive spread throughout the countries of the world, there is emerging interest for the potential long-term consequences of suffering from a COVID-19 pneumonia. Imaging plays a central role in the diagnosis and management of COVID-19 pneumonia, with chest X-ray examinations and computed tomography (CT) being undoubtedly the modalities most widely used, allowing for a fast and sensitive detection of infiltration patterns associated with COVID-19 pneumonia. For a better understanding of underlying pathomechanisms of pulmonary damage, longitudinal imaging series are warranted, for which CT is of limited usability due to repeated exposure of X-rays. Recent advances in MRI suggested that high-performance low-field MRI might represent a valuable method for pulmonary imaging without the need of radiation exposure. However, so far, low-field MRI has not been applied to study pulmonary damage after COVID-19 pneumonia. We present a case report of a patient who suffered from COVID-19 pneumonia using 0.55 T MRI for follow-up examinations three months after initial infection. Low-field MRI enables a precise visualization of persistent pulmonary changes including ground-glass opacities, which are consistent with CT performed on the same day. Low-field MRI seems to be feasible in the detection of pulmonary involvement in patients with COVID-19 pneumonia and may have the potential for repetitive lung examinations in monitoring the reconvalescence after pulmonary infections.

Conflict of interest statement

D.G. and W.H. are employees of Siemens Healthcare GmbH. The other authors have nothing to declare.

Copyright © 2020 Elsevier Inc. All rights reserved.

Figures

Fig. 1

a) Chest computed tomography (CT) demonstrating patchy GGOs with a peripheral distribution 3 months after COVID-19 infection in a patient in his early 60s. b) Adjacent MRI images of the patient using a high-performance low-field MRI at 0.55 T with an intermediate-weighted BLADE sequence (FoV 379x379mm2, TE 43 ms, TR 5335 ms. Slice Thickness 5 mm) demonstrating corresponding patchy GGO in accordance to the chest CT. MRI images and CT differ in some kind due to the breathing mobility, as CT was acquired in inspiration and respectively the MRI in expiration. Image acquisition in expiration and longer scanning times explain the dystelectases in the lower lobes, which partially unmark findings in the dorsal lung parts. c) Adjacent MRI images of the patient using a high-performance low-field MRI at 0.55 T with an intermediate-weighted BLADE sequence (FoV 379x379mm2, TE 43 ms, TR 5335 ms. Slice Thickness 5 mm) demonstrating corresponding patchy GGO in accordance to the chest CT. MRI images and CT differ in some kind due to the breathing mobility, as CT was acquired in inspiration and respectively the MRI in expiration. Image acquisition in expiration and longer scanning times explain the dystelectases in the lower lobes, which partially unmark findings in the dorsal lung parts.

Fig. 2

Repetition of the MRI scan two weeks later revealed no significant changes of the presentation of GGOs using the PD BLADE MRI (FoV 379x379mm2, TE 43 ms, TR 5335 ms. Slice Thickness 5 mm) sequence.