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

The comparative study of T1-weighted star-vibe sequence and computed tomography for the assessment of pulmonary parenchyma diseases

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 freebreathing 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 were 100% 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.