3T磁共振系统下的3D氧增强磁共振成像：与薄层CT在吸烟者慢性阻塞性肺疾病肺功能丧失评估及临床分期分类定量能力方面的比较
3D Oxygen-Enhanced MRI at 3T MR System: Comparison With Thin-Section CT of Quantitative Capability for Pulmonary Functional Loss Assessment and Clinical Stage Classification of COPD in Smokers.
作者信息
Ohno Yoshiharu, Yui Masao, Yoshikawa Takeshi, Seki Shinichiro, Takenaka Daisuke, Kassai Yoshimori, Hattori Hidekazu, Murayama Kazuhiro, Toyama Hiroshi
机构信息
Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan.
Joint Laboratory Research of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan.
出版信息
J Magn Reson Imaging. 2021 Apr;53(4):1042-1051. doi: 10.1002/jmri.27441. Epub 2020 Nov 17.
BACKGROUND
Oxygen (O )-enhanced MRI is mainly performed by a 2D sequence using 1.5T MR systems but trying to be obtained by a 3D sequence using a 3T MR system.
PURPOSE
To compare the capability of 3D O -enhanced MRI and that of thin-section computed tomography (CT) for pulmonary functional loss assessment and clinical stage classification of chronic obstructive pulmonary disease (COPD) in smokers.
STUDY TYPE
Prospective study.
POPULATION
Fifty six smokers were included.
FIELD STRENGTH/ SEQUENCE: 3T, 3D O -enhanced MRIs were performed with a 3D T -weighted fast field echo pulse sequence using the multiple flip angles.
ASSESSMENTS
Smokers were classified into four stages ("Without COPD," "Mild COPD," "Moderate COPD," "Severe or very severe COPD"). Maps of regional changes in T values were generated from O -enhanced MR data. Regions of interest (ROIs) were then placed over the lung on all slices and averaged to determine mean T value change (ΔT ). Quantitative CT used the percentage of low attenuation areas within the entire lung (LAA%).
STATISTICAL TESTS
ΔT and LAA% were correlated with pulmonary functional parameters, and compared for four stages using Tukey's Honestly Significant Difference test. Discrimination analyses were performed and McNemar's test was used for a comparison of the accuracy of the indexes.
RESULTS
There were significantly higher correlations between ΔT and pulmonary functional parameters (-0.83 ≤ r ≤ -0.71, P < 0.05) than between LAA% and the same pulmonary functional parameters (-0.76 ≤ r ≤ -0.69, P < 0.05). ΔT and LAA% of the "Mild COPD" and "Moderate COPD" groups were significantly different from those of the "Severe or Very Severe COPD" group (P < 0.05). Discriminatory accuracy of ΔT (62.5%) and ΔT1 with LAA% (67.9%) was significantly greater than that of LAA% (48.2%, P < 0.05).
DATA CONCLUSION
Compared with thin-section CT, 3D O -enhanced MRI has a similar capability for pulmonary functional assessment but better potential for clinical stage classification in smokers.
LEVEL OF EVIDENCE
2 TECHNICAL EFFICACY STAGE: 1.
背景
氧（O）增强磁共振成像（MRI）主要通过使用1.5T MR系统的二维序列进行，但目前正尝试通过使用3T MR系统的三维序列来实现。
目的
比较三维O增强MRI与薄层计算机断层扫描（CT）对吸烟者慢性阻塞性肺疾病（COPD）肺功能丧失评估及临床分期的能力。
研究类型
前瞻性研究。
研究对象
纳入56名吸烟者。
场强/序列：采用3T，使用三维T加权快速场回波脉冲序列并采用多个翻转角进行三维O增强MRI检查。
评估
吸烟者被分为四个阶段（“无COPD”、“轻度COPD”、“中度COPD”、“重度或极重度COPD”）。从O增强MR数据生成T值区域变化图。然后在所有层面的肺上放置感兴趣区（ROI）并求平均值以确定平均T值变化（ΔT）。定量CT采用全肺低衰减区百分比（LAA%）。
统计检验
ΔT和LAA%与肺功能参数进行相关性分析，并使用Tukey真实显著性差异检验对四个阶段进行比较。进行判别分析，并使用McNemar检验比较各指标的准确性。
结果
与LAA%和相同肺功能参数之间的相关性（-0.76≤r≤-0.69，P<0.05）相比，ΔT与肺功能参数之间的相关性（-0.83≤r≤-0.71，P<0.05）显著更高。“轻度COPD”和“中度COPD”组的ΔT和LAA%与“重度或极重度COPD”组的显著不同（P<0.05）。ΔT（62.5%）和ΔT1联合LAA%（67.9%）的判别准确性显著高于LAA%（48.2%，P<0.05）。
数据结论
与薄层CT相比，三维O增强MRI在肺功能评估方面能力相似，但在吸烟者临床分期方面具有更好的潜力。
证据水平
2级 技术效能阶段：1级
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