Diagnostic accuracy of 3-T lung magnetic resonance imaging in human immunodeficiency virus-positive children
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.
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.
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%).
Thoracic MRI at 3 T demonstrates a high sensitivity and specificity for detecting nodules >4 mm, effusion and lymphadenopathy in HIV-positive children.
Keywords3-T Children Human immunodeficiency virus Lung Magnetic resonance imaging
The authors acknowledge Ms. Kusum Chopra and Mr. Ramesh Goel for statistical analysis of this manuscript.
Compliance with ethical standards
Conflicts of interest
- 1.(2019) Global HIV/AIDS overview. AIDS.gov. https://www.aids.gov/federal-resources/around.../global-aids-overview. Accessed 29 Aug 2019
- 3.Akinbami AA, Adegboyega AO, Oshinaike OO et al (2011) Chest X-ray findings in HIV patients in relation to the CD4 count. Nig Q J Hosp Med 21:306–311Google Scholar
- 4.Welte T (2014) Imaging in the diagnosis of lung disease: more sophisticated methods require greater interdisciplinary collaboration. Dtsch Arztebl Int 111:179–180Google Scholar
- 5.American College of Radiology (ACR) (2019) ACR appropriateness criteria: acute respiratory illness in HIV-positive patients. www.acr.org/SecondaryMainMenuCategories/quality_safety/app_criteria/pdf/ExpertPanelonThoracicImaging/AcuteRespiratoryIllnessinHIVPositivePatients-Doc2.aspx. Accessed 29 Aug 2019
- 28.Montella S, Santamaria F, Salvatore M (2009) Assessment of chest high-field magnetic resonance imaging in children and young adults with noncystic fibrosis chronic lung disease: comparison to high-resolution computed tomography and correlation with pulmonary function. Investig Radiol 44:532–538CrossRefGoogle Scholar