Abstract
To evaluate the usefulness of MRI with DWI for distinguishing lung findings in investigation of primary pulmonary haemosiderosis.
We enrolled 31 patients with clinically confirmed primary pulmonary haemosiderosis who underwent magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI). Male patients were 20 (65.52%), female 11 (34.48%). Patients were from 17 to 83 years old. Two thoracic radiologists reviewed MR images including unenhanced T1- and T2-weighted images, gadolinium-enhanced images and DWI images.
MRI findings present three types of haemosiderosis. First was pulmonary haemosiderosis associated with antibody to the basement membrane of the lung and kidney (Goodpasture's syndrome). There were 20 patients. They had signal suppression on high-b-value DW images or high apparent diffusion coefficient (ADC) values of more than 5.4×10-3 mm2/s (P<0.001). Second were pulmonary haemosiderosis associated with hypersensitivity to proteins in cow's milk (Heiner syndrome). They had ADC values of more than 3.8×10-3 mm2/s (P<0.001). Third were idiopathic pulmonary haemosiderosis. They had ADC values of more than 4.8×10-3 mm2/s (P<0.001). Mortal rate was 24.14% in child cases. Follow up MRI was performed in all patients after therapy with iron deposits after two years after diagnosis.
Pulmonary disease caused by milk allergy may be a rare presentation but should be thought of in a child with recurrent infections and pulmonary infiltrates. Distinguishing and determining of pulmonary haemosiderosis is important for proper medical treatment. MRI with DWI is usefulness for determining of.
- Copyright ©ERS 2015