目的探讨半剂量钆对比剂延迟增强T_(1)W_(I)磁化传递对比(T_(1)-MTC)、T_(2)液体衰减反转恢复(T_(2)-FLAIR)序列对脑转移瘤的诊断价值。方法选择确诊肿瘤并明确有脑转移瘤患者61例,共有脑转移病灶528个。MRI检查采用半剂量钆对比剂(0.05...目的探讨半剂量钆对比剂延迟增强T_(1)W_(I)磁化传递对比(T_(1)-MTC)、T_(2)液体衰减反转恢复(T_(2)-FLAIR)序列对脑转移瘤的诊断价值。方法选择确诊肿瘤并明确有脑转移瘤患者61例,共有脑转移病灶528个。MRI检查采用半剂量钆对比剂(0.05 mmol/kg),分别在增强后30 min行轴位T_(1)-MTC、T_(2)-FLAIR扫描,增强后35 min时注射另一半对比剂(0.05 mmol/kg)后行多角度T_(1)-FLAIR扫描。由两位放射科医师以双盲法观察增强30 min T_(1)-MTC、T_(2)-FLAIR及35 min T_(1)-FLAIR图像,评价不同时间、序列所检出的脑转移瘤数量及显示的准确率。观察脑转移瘤的强化方式,请两位医师评价病灶的信号强度(SI lesion)、对侧正常脑组织的信号强度(SI brain)、背景空气的标准差(SD noise),采用组内相关系数(ICC)对两位医师的诊断进行一致性评价。测量直径≥1.0 cm脑转移病灶的SI lesion、SI brain、SD noise,计算在30 min T_(1)-MTC、T_(2)-FLAIR序列及35 min T_(1)-FLAIR序列中肿瘤与对侧正常脑组织的信号比、对比率(CBR)、与背景的对比噪声比(CNR)及信噪比(SNR)。结果30 min T_(1)-MTC+30 min T_(2)-FLAIR显示准确率高于30 min T_(1)-MTC、30 min T_(2)-FLAIR、35 min T_(1)-FLAIR(P均<0.05),30 min T_(1)-MTC、30 min T_(2)-FLAIR及35 min T_(1)-FLAIR显示准确率比较差异无统计学意义(P均>0.05)。脑转移瘤在30 min T_(1)-MTC图像表现为明显均匀强化42例(68.85%)、明显不均匀强化19例(31.15%);脑转移瘤在30 min T_(2)-FLAIR图像表现为明显不均匀强化35例(57.38%)、环状强化26例(42.62%)。ICC分析显示,两位医师对30 min T_(1)-MTC、30 min T_(2)-FLAIR、35 min T_(1)-FLAIR序列脑转移瘤SI lesion、SI brain、SD noise诊断的一致性均较好(ICC值均>0.80)。30 min T_(2)-FLAIR信号比、CBR、CNR、SNR均高于30 min T_(1)-MTC、35 min T_(1)-FLAIR,30 min T_(1)-MTC CNR、SNR均高于35 min T_(1)-FLAIR(P均<0.05);30minT_(1)-MTC与35minT_(1)-FLAIR信号比、CBR比较差异均无统计学意义(P均>0.05)。结论半剂量钆对比剂延迟增强30minT_(1)-MTC、T_(2)-FLAIR序列对脑转移瘤具有较好的诊断价值,两者结合可提高诊断的准确性。展开更多
Objective: To determine long term reproducibility of the late enhancement(LE) signal in contrast enhanced magnetic resonance imaging(MRI) and potential changes of the signal after revascularisation. Methods: 33 patien...Objective: To determine long term reproducibility of the late enhancement(LE) signal in contrast enhanced magnetic resonance imaging(MRI) and potential changes of the signal after revascularisation. Methods: 33 patients(29 men, mean(SD)61(11) years) with coronary artery disease(CAD) and left ventricular dysfunction(ejection fraction 30(7)%) underwent two contrast enhanced MRI procedures within 9(3) months. Fifteen patients(group A: 14 men, 59(12) years) had no interventions between the two studies. Eighteen patients underwent revascularisation after MRI 1(group B: 15 men, 62(9) years). Changes in the LE signal between the first and second MRIs were investigated in both groups as well as intraobserver and interobserver variabilities for delineation of the signal. Results: The LE signal was highly reproducible in groups A and B for segmental analysis(concordance 86%v 82%, respectively; κ=0.70 v 0.67) and summed scores(group A: r=0.97, p< 0.001; group B: r=0.93, p< 0.001). The LE signal was quantified as 27(27) cm3 in group A versus 30(16) cm3 in group B in the first MRI and 26(25) cm3 versus 30(15) cm3, respectively, for the second MRI(both not significant). Moreover, low intraobserver and interobserver variabilities were observed in segmental analysis(κ=0.86 and 0.74, respectively, for group A, and κ=0.87 and 0.82, respectively, for group B). Conclusion: In patients with chronic CAD, the LE signal in contrast enhanced MRI is very stable over an extended time period. These results further characterise contrast enhanced MRI as a useful tool for myocardial viability assessment. Low intraobserver and interobserver variabilities promise robustness of the method for clinical application.展开更多
文摘目的探讨半剂量钆对比剂延迟增强T_(1)W_(I)磁化传递对比(T_(1)-MTC)、T_(2)液体衰减反转恢复(T_(2)-FLAIR)序列对脑转移瘤的诊断价值。方法选择确诊肿瘤并明确有脑转移瘤患者61例,共有脑转移病灶528个。MRI检查采用半剂量钆对比剂(0.05 mmol/kg),分别在增强后30 min行轴位T_(1)-MTC、T_(2)-FLAIR扫描,增强后35 min时注射另一半对比剂(0.05 mmol/kg)后行多角度T_(1)-FLAIR扫描。由两位放射科医师以双盲法观察增强30 min T_(1)-MTC、T_(2)-FLAIR及35 min T_(1)-FLAIR图像,评价不同时间、序列所检出的脑转移瘤数量及显示的准确率。观察脑转移瘤的强化方式,请两位医师评价病灶的信号强度(SI lesion)、对侧正常脑组织的信号强度(SI brain)、背景空气的标准差(SD noise),采用组内相关系数(ICC)对两位医师的诊断进行一致性评价。测量直径≥1.0 cm脑转移病灶的SI lesion、SI brain、SD noise,计算在30 min T_(1)-MTC、T_(2)-FLAIR序列及35 min T_(1)-FLAIR序列中肿瘤与对侧正常脑组织的信号比、对比率(CBR)、与背景的对比噪声比(CNR)及信噪比(SNR)。结果30 min T_(1)-MTC+30 min T_(2)-FLAIR显示准确率高于30 min T_(1)-MTC、30 min T_(2)-FLAIR、35 min T_(1)-FLAIR(P均<0.05),30 min T_(1)-MTC、30 min T_(2)-FLAIR及35 min T_(1)-FLAIR显示准确率比较差异无统计学意义(P均>0.05)。脑转移瘤在30 min T_(1)-MTC图像表现为明显均匀强化42例(68.85%)、明显不均匀强化19例(31.15%);脑转移瘤在30 min T_(2)-FLAIR图像表现为明显不均匀强化35例(57.38%)、环状强化26例(42.62%)。ICC分析显示,两位医师对30 min T_(1)-MTC、30 min T_(2)-FLAIR、35 min T_(1)-FLAIR序列脑转移瘤SI lesion、SI brain、SD noise诊断的一致性均较好(ICC值均>0.80)。30 min T_(2)-FLAIR信号比、CBR、CNR、SNR均高于30 min T_(1)-MTC、35 min T_(1)-FLAIR,30 min T_(1)-MTC CNR、SNR均高于35 min T_(1)-FLAIR(P均<0.05);30minT_(1)-MTC与35minT_(1)-FLAIR信号比、CBR比较差异均无统计学意义(P均>0.05)。结论半剂量钆对比剂延迟增强30minT_(1)-MTC、T_(2)-FLAIR序列对脑转移瘤具有较好的诊断价值,两者结合可提高诊断的准确性。
文摘Objective: To determine long term reproducibility of the late enhancement(LE) signal in contrast enhanced magnetic resonance imaging(MRI) and potential changes of the signal after revascularisation. Methods: 33 patients(29 men, mean(SD)61(11) years) with coronary artery disease(CAD) and left ventricular dysfunction(ejection fraction 30(7)%) underwent two contrast enhanced MRI procedures within 9(3) months. Fifteen patients(group A: 14 men, 59(12) years) had no interventions between the two studies. Eighteen patients underwent revascularisation after MRI 1(group B: 15 men, 62(9) years). Changes in the LE signal between the first and second MRIs were investigated in both groups as well as intraobserver and interobserver variabilities for delineation of the signal. Results: The LE signal was highly reproducible in groups A and B for segmental analysis(concordance 86%v 82%, respectively; κ=0.70 v 0.67) and summed scores(group A: r=0.97, p< 0.001; group B: r=0.93, p< 0.001). The LE signal was quantified as 27(27) cm3 in group A versus 30(16) cm3 in group B in the first MRI and 26(25) cm3 versus 30(15) cm3, respectively, for the second MRI(both not significant). Moreover, low intraobserver and interobserver variabilities were observed in segmental analysis(κ=0.86 and 0.74, respectively, for group A, and κ=0.87 and 0.82, respectively, for group B). Conclusion: In patients with chronic CAD, the LE signal in contrast enhanced MRI is very stable over an extended time period. These results further characterise contrast enhanced MRI as a useful tool for myocardial viability assessment. Low intraobserver and interobserver variabilities promise robustness of the method for clinical application.
