Johkoh T, Müller N L, Kavanagh P V, Cartier Y, Mayo J R, Tomiyama N, Murakami T, Naito H, Nakamura H, Moriya H
Department of Radiology, University of British Columbia and Vancouver Hospital and Health Sciences Center, Canada.
Radiat Med. 2000 Sep-Oct;18(5):277-81.
To compare MR perfusion imaging with perfusion scintigraphy in the evaluation of patients with pulmonary emphysema being considered for lung volume reduction surgery.
Six patients with pulmonary emphysema and two normal individuals were evaluated by MR perfusion imaging, perfusion scintigraphy, and selective bilateral pulmonary angiography. MR images were obtained with an enhanced fast gradient recalled echo with three-dimensional Fourier transformation technique (efgre 3D) (6.3/1.3; flip angle, 30 degrees; field of view, 45-48 cm; matrix, 256 x 160). The presence or absence of perfusion defects in each segment was evaluated by two independent observers.
Using angiography as the gold standard, the sensitivity, specificity, and accuracy of MR perfusion imaging in detecting focal perfusion abnormalities were 90%, 87%, and 89%, respectively, while those of perfusion scintigraphy were 71%, 76%, and 71%, respectively. The diagnostic accuracy of MR perfusion imaging was significantly higher than that of scintigraphy (p<0.001, McNemar test). There was good agreement between two observers for MR perfusion imaging (kappa statistic, 0.66) and only moderate agreement for perfusion scintigraphy (kappa statistic, 0.51).
MR perfusion imaging is superior to perfusion scintigraphy in the evaluation of pulmonary parenchymal perfusion in patients with pulmonary emphysema.
比较磁共振灌注成像与灌注闪烁显像在评估拟行肺减容手术的肺气肿患者中的应用。
对6例肺气肿患者和2名正常个体进行了磁共振灌注成像、灌注闪烁显像及选择性双侧肺血管造影评估。采用增强快速梯度回波三维傅里叶变换技术（efgre 3D）（6.3/1.3；翻转角30°；视野45 - 48 cm；矩阵256×160）获取磁共振图像。由两名独立观察者评估各肺段有无灌注缺损。
以血管造影作为金标准，磁共振灌注成像检测局灶性灌注异常的敏感性、特异性和准确性分别为90%、87%和89%，而灌注闪烁显像的分别为71%、76%和71%。磁共振灌注成像的诊断准确性显著高于闪烁显像（p<0.001，McNemar检验）。两名观察者对磁共振灌注成像的一致性良好（kappa统计量，0.66），而对灌注闪烁显像的一致性仅为中等（kappa统计量，0.51）。
在评估肺气肿患者的肺实质灌注方面，磁共振灌注成像优于灌注闪烁显像。
