Interstitial Lung Disease

Imaging is important in the differential diagnosis as well as in the assessment of functional constraints and therapy response in interstitial lung disease. Imaging has to address three main topics: (1) visualization and recognition of morphological changes and their patterns; (2) assessment of pulmonary function, i.e. restrictive ventilatory impairment, reduction of perfusion and gas exchange; and (3) assessment of inflammatory activity. MRI is capable to provide image-based answers to all three topics. Typical patterns, such as reticular and reticulonodular changes, ground glass, consolidation and honey-combing are easily visualized. Functional imaging using contrast-enhanced perfusion MRI and ventilation MRI with hyperpolarized gases or oxygen are available for the assessment of restrictive constraints. Routine contrast-enhanced MRI allows estimating inflammatory activity in different types of interstitial lung disease which is a clear advantage over CT which has limitations in this regard.