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Silicosis-induced pulmonary artery stenosis: demonstration by MR angiography and perfusion MRI

Departments of ¹Diagnostic Radiology and ²Internal Medicine, University of Technology Aachen, Aachen, Germany

View larger version (178K): [in a new window]   Figure 1. Chest radiograph shows small irregular opacities with a reticulonodular pattern as well as bilateral hilar lymphandenopathy. Post-operative changes from diagnostic thoracotomy 10 years previously are visible in the lower zone of the left lung.

View larger version (41K): [in a new window]   Figure 2. (a) Contrast enhanced CT demonstrates partly calcified lymph nodes at the right hilum (arrows), close to the upper right pulmonary artery. (b) CT also shows enlarged calcified left hilar lymph nodes (arrows).

View larger version (40K): [in a new window]   Figure 3. Maximum intensity projection reconstructions of 3D MR angiography (TR 3.7, TE 1.1, flip angle 40°) clearly depict stenosis of the lower left (arrow) and upper right (curved arrow) pulmonary artery, as well as a minor stenosis of the proximal lower right pulmonary artery (arrowhead). The locations of the stenoses correlate with the calcified hilar lymph nodes shown on CT. (b) Dynamic perfusion MR images (TR 2.5, TE 0.7) of the lung show a perfusion deficit of the upper zones of the right lung and the lower zones of the left lung (left-hand image). After 8 s the perfusion deficit is evened out (right-hand image). This finding results from the pulmonary artery stenoses.