T1加权STAR VIBE序列与CT成像在评估肺实质疾病中的对比研究
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摘要
目的探索胸部磁共振T1加权STAR-VIBE序列与CT成像在评估肺实质疾病中的应用价值。材料与方法收集陕西中医药大学附属医院同时行胸部磁共振STARVIBE序列和CT成像且检出胸部疾病患者30例。观察STAR-VIBE序列及CT图像肺肿块(≥3cm)、结节(<3cm)、实变、斑片状影、条索状影、网状影、磨玻璃密度影、纵隔淋巴结、胸膜增厚、胸腔积液、肺气肿、肺大泡、牵引性支气管扩张征象。由具有25年工作经验的胸部影像科医师对CT图像疾病征象进行观察并作为参考标准。由另外两名具有5年以上工作经验的影像科医师对STAR-VIBE及CT图像疾病征象采用五分法进行双盲法独立评价,计算STAR-VIBE序列各种疾病征象的检出率。结果 STARVIBE序列肺肿块、实变、纵隔淋巴结和胸腔积液的检出率均为100%,STAR-VIBE与CT主观评分均大于4分,且两者间差异无统计学意义(P>0.05)。STAR-VIBE序列可以检出94.2%和92.9%的肺结节和胸膜增厚,磨玻璃密度、斑片状影、网状影、条索状影在STAR-VIBE序列的检出率依次为80.1%、85.2%、85.7%、88.0%,牵拉性支气管扩张的检出率(66.7%)高于肺气肿和肺大泡检出率,且低于其他胸部疾病征象检出率,且STAR-VIBE序列各种征象主观评分均高于3分。磁共振STAR-VIBE序列无法检出肺气肿和肺大泡,且STAR-VIBE序列主观评分低于2分。结论胸部MR成像STAR-VIBE序列对于评估肺和纵隔疾病是可行的,且在无辐射剂量前提下帮助评估多种肺实质疾病的影像学表现。
Objective: To explore the performance of pulmonary MR imaging with free-breathing T1-weighted star vibe sequence and computed tomography(CT) in the assessment of pulmonary parenchyma diseases. Materials and Methods: 30 consecutive patients with various pulmonary parenchyma lesions were detected on chest thin-section standard-dose CT as well as pulmonary MR imaging with star vibe. Pulmonary parenchyma diseases were assessed on star vibe sequence and CT images, including masses(≥3 cm), nodules(<3 cm), consolidation,patchy shadow, cords focal, mesh shadow, ground glass density, mediastinal lymph nodes,pleural thickening, pleural effusion, emphysema, pulmonary bullae, traction bronchiectasis and so on. Chest CT images of each patient were reviewed by a chest radiologists with 25 years of experience, and the results were used as the reference standard for radiological findings. Then all images obtained with standard-dose CT and star vibe sequence were independently and doubleblindly evaluated by two chest radiologists using a 5-point scoring criteria. The detection rate of star-vibe sequence for pulmonary parenchyma diseases was calculated. Results: The detection rates of pulmonary masses, consolidation, mediastinal lymph nodes and pleural effusion were100% with STAR-VIBE sequence, the subjective scores of which were higher than 4-point and showed no significant difference between STAR-VIBE and CT(P>0.05). The MR imaging can detect pulmonary nodules and pleural thickening with a high rate about 94.2% and 92.9%, and the ground glass density, patchy shadow,mesh shadow, cords focal can also be displayed at a high rate with 80.1%, 85.2%, 85.7% and 88.0%, and the detection rates of traction bronchiectasis(66.7%) was higher than emphysema and bullae and lower than other pulmonary emphysema diseases, the subjective scores of which with STAR-VIBE were higher than 3-point. The pulmonary MR free-breathing T1-weighted 3D star vibe would miss all emphysema and bullae, and the subjective score were less than 2-point with STAR-VIBE. Conclusions: Pulmonary MR imaging with free-breathing T1-weighted 3D STAR-VIBE sequence is feasible for the assessment of pulmonary and mediastinal diseases and help to evaluate the radiological findings for patients with various pulmonary parenchyma diseases without radiation dose.
Objective: To explore the performance of pulmonary MR imaging with free-breathing T1-weighted star vibe sequence and computed tomography(CT) in the assessment of pulmonary parenchyma diseases. Materials and Methods: 30 consecutive patients with various pulmonary parenchyma lesions were detected on chest thin-section standard-dose CT as well as pulmonary MR imaging with star vibe. Pulmonary parenchyma diseases were assessed on star vibe sequence and CT images, including masses(≥3 cm), nodules(<3 cm), consolidation,patchy shadow, cords focal, mesh shadow, ground glass density, mediastinal lymph nodes,pleural thickening, pleural effusion, emphysema, pulmonary bullae, traction bronchiectasis and so on. Chest CT images of each patient were reviewed by a chest radiologists with 25 years of experience, and the results were used as the reference standard for radiological findings. Then all images obtained with standard-dose CT and star vibe sequence were independently and doubleblindly evaluated by two chest radiologists using a 5-point scoring criteria. The detection rate of star-vibe sequence for pulmonary parenchyma diseases was calculated. Results: The detection rates of pulmonary masses, consolidation, mediastinal lymph nodes and pleural effusion were100% with STAR-VIBE sequence, the subjective scores of which were higher than 4-point and showed no significant difference between STAR-VIBE and CT(P>0.05). The MR imaging can detect pulmonary nodules and pleural thickening with a high rate about 94.2% and 92.9%, and the ground glass density, patchy shadow,mesh shadow, cords focal can also be displayed at a high rate with 80.1%, 85.2%, 85.7% and 88.0%, and the detection rates of traction bronchiectasis(66.7%) was higher than emphysema and bullae and lower than other pulmonary emphysema diseases, the subjective scores of which with STAR-VIBE were higher than 3-point. The pulmonary MR free-breathing T1-weighted 3D star vibe would miss all emphysema and bullae, and the subjective score were less than 2-point with STAR-VIBE. Conclusions: Pulmonary MR imaging with free-breathing T1-weighted 3D STAR-VIBE sequence is feasible for the assessment of pulmonary and mediastinal diseases and help to evaluate the radiological findings for patients with various pulmonary parenchyma diseases without radiation dose.
引文
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[9]Li WC, Wang D, Zheng NH, et al. Comparative on image quality of liverbetweenconventional3Dvolumetricinterpolatedbreath-hold examination sequence and free-breathing Star VIBE sequence T1WI.Chin J Med Imaging Technol, 2018, 34(7):1094-1098.李武超,王頔,郑念华,等.常规三维容积内插屏气检查序列与自由呼吸StarVIBE序列T1WI肝脏图像质量对比.中国医学影像技术, 2018,34(7):1094-1098.
[10]Cieszanowski A, Lisowska A, Dabrowska M, et al. MR imaging of pulmonary nodules:Detection rate and accuracy of size estimation in comparison to computed tomography. PLoS One, 2016, 11:e0156272.
[2]Khalil A, Majlath M, Gounant V, et al. Contribution of magnetic resonance imaging in lung cancer imaging. Diagn IntervImaging, 2016,97(10):991-1002.
[3]Xia Y, Guan Y, Liu SY, et al. The preliminary application of ultra-short echo time(UTE)MR pulmonary imaging in COPD. J Clin Radiol, 2018,37(3):401-405.夏艺,管宇,刘士远,等.超短回波时间(U T E)肺部M R成像对慢性阻塞性肺疾病的初步应用.临床放射学杂志,2018,37(3):401-405.
[4]Zhang DX, Zhu SC, Guan S, et al. The value of MR intravoxel incoherentmotiondiffusionweightedimaginginTstageand differentiateddegreeofrectaladenocarcinoma.ChinJMagnReson Imaging, 2016, 7(8):561-566.张单霞,朱绍成,管枢,等. MR体素内不相干运动扩散加权成像对直肠腺癌T分期及分化程度的应用价值研究.磁共振成像, 2016, 7(8):561-566.
[5]Kumar S, Rai R, Stemmer A, et al. Feasibility of free breathing lung MRI for Radiotherapy using non-Cartesian k-space acquisition schemes.Br J Radiol, 2017, 90(1080):20170037.
[6]Chandarana H, Block KT, Winfeld MJ, et al. Free-breathing contrastenhancedT1-weightedgradient-echoimagingwithradialk-space sampling for paediatric abdominopelvic MRI. Eur Radiol, 2014, 24(2):320-326.
[7]Schwenzer NF, Seith F, Gatidis S, et al. Diagnosing lung nodules on oncologic MR/PET imaging:comparison of fast T1-weighted sequences and influence of image acquisition in inspiration and expiration breathhold. Korean J Radiol, 2016, 17(5):684-694.
[8]Schaarschmidt B, Buchbender C, Gomez B, et al. Thoracic staging ofnon-small-celllungcancerusingintegrated(18)F-FDGPET/MR imaging:diagnostic value of different MR sequences. Eur J Nucl Med Mol Imaging, 2015, 42(8):1257-1267.
[9]Li WC, Wang D, Zheng NH, et al. Comparative on image quality of liverbetweenconventional3Dvolumetricinterpolatedbreath-hold examination sequence and free-breathing Star VIBE sequence T1WI.Chin J Med Imaging Technol, 2018, 34(7):1094-1098.李武超,王頔,郑念华,等.常规三维容积内插屏气检查序列与自由呼吸StarVIBE序列T1WI肝脏图像质量对比.中国医学影像技术, 2018,34(7):1094-1098.
[10]Cieszanowski A, Lisowska A, Dabrowska M, et al. MR imaging of pulmonary nodules:Detection rate and accuracy of size estimation in comparison to computed tomography. PLoS One, 2016, 11:e0156272.