Which sequence should be used in the thorax magnetic resonance imaging of COVID-19: a comparative study

Authors: AYŞE ŞULE ATEŞ, BURAK YAĞDIRAN, ONUR TAYDAŞ, ÖMER FARUK ATEŞ

Abstract: Background and aim: To evaluate and compare magnetic resonance imaging (MRI) sequences that could potentially be used in the diagnosis of coronavirus disease 2019 (COVID-19). Materials and methods: Included in the study were 42 patient who underwent thorax computed tomography (CT) for COVID-19 pneumonia and thorax MRI for any reason within 24 h after CT. The T2-weighted fast spin echo periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) (T2W-FSE-P), fast imaging employing steady-state acquisition, T2 fat-saturated FSE, axial T1 liver acquisition with volume acceleration (LAVA) and single-shot FSE images were compared in terms of their ability to show COVID-19 findings. Results: The mean age of the patients was 47.2 ± 24 years. Of the patients, 22 were male (52.4%) and 20 (47.6%) were female. The interobserver intraclass coefficient (ICC) for the image quality score was the highest in the T2W-FSE-P sequence and lowest in the T1 LAVA sequence. All of the lesion-based evaluations of the interobserver agreement were statistically significant, with the kappa value varying between 0.798 and 0.998. Conclusion: All 5 sequences evaluated in the study were successful in showing the parenchymal findings of COVID-19. Since the T2WFSE-P sequence had the best scores in both interobserver agreement and ICC for the image quality score, it was considered that it can be included in thorax MRI examinations to assist the diagnosis of COVID-19.

Keywords: COVID-19, magnetic resonance imaging, sequence, interobserver intraclass coefficients, interobserver agreement

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