MRI Findings in Covid-19 Patients with Lung Involvement Before and After the Treatment: Comparative Study

Abstract

Objectives: Advancements in Magnetic Resonance Imaging technology have positioned it as a viable alternative to other imaging techniques, such as Computed Tomography scans. Given the high incidence of lung involvement in viral infections, particularly coronavirus, this study evaluated MRI's effectiveness in diagnosing lung involvement in COVID-19 patients before and after treatment.
Methods and materials: This cross-sectional study involved 20 patients with a mean age of 49 ± 12.14 years, suspected of having COVID-19, who were admitted to Shahid Rahnemoun Hospital in Yazd, Iran. All participants underwent thorax MRI scans before and 2 weeks after treatment. Two highly experienced radiologists with over a decade of clinical and academic expertise analysed the MRI images. The number of lobes affected, number of lobes containing Ground Glass Opacities and consolidation, number of nodules, distribution of lesions, fibrosis, and the presence of pleural effusion were recorded. A comparative analysis was conducted to assess the proportion of patients with lesions on T2-weighted imaging and diffusion-weighted imaging before and after treatment, based on the McNamara criteria. The statistical significance threshold was set at p < 0.05 for all criteria.
Results: The results of this study demonstrated a statistically significant decrease in the percentage of pulmonary involvement in the right lower lobe (RLL), right middle lobe (RML), left middle lobe (LML), and left upper lobe (LUL) of patients after treatment (P<0.05). Before treatment, 55% of patients (11 cases) exhibited lung involvement above 25% in MRI scans, while only 25% (5 cases) showed this level of involvement post-treatment. McNemar's statistical test confirmed the significant reduction in pulmonary involvement in MRI after treatment (P<0.05). Further analysis using McNemar's test revealed a significant difference in the number of Ground Glass Opacities (GGO) reported in MRI scans before and after treatment. However, the differences observed in consolidation, atelectasis, and fibrosis were not statistically significant (P>0.05).
Conclusion: These findings provide valuable insights into the diagnostic capabilities of MRI in assessing COVID-19 lung involvement and the impact of treatment on pulmonary conditions. Although thorax CT is widely used in the imaging of COVID-19 infection, due to its advantages, MRI can also be used as an alternative diagnostic tool.