Heywang-Köbrunner S H, Bick U, Bradley W G, Boné B, Casselman J, Coulthard A, Fischer U, Müller-Schimpfle M, Oellinger H, Patt R, Teubner J, Friedrich M, Newstead G, Holland R, Schauer A, Sickles E A, Tabar L, Waisman J, Wernecke K D
Department of Diagnostic Radiology, University Hospital Halle, Magdeburger Strasse 16, 06112 Halle, Germany.
Eur Radiol. 2001;11(4):531-46. doi: 10.1007/s003300000745.
A multicentre study was undertaken to provide fundamentals for improved standardization and optimized interpretation guidelines of dynamic contrast-enhanced MRI. Only patients scheduled for biopsy of a clinical or imaging abnormality were included. They underwent standardized dynamic MRI on Siemens 1.0 (163 valid lesions > or = 5 mm) or 1.5 T (395 valid lesions > or = 5 mm) using 3D fast low-angle shot (FLASH; 87 s) before and five times after standardized bolus of 0.2 mmol Gd-DTPA/kg. One-Tesla and 1.5 T data were analysed separately using a discriminant analysis. Only histologically correlated lesions entered the statistical evaluation. Histopathology and imaging were correlated in retrospect and in open. The best results were achieved by combining up to five wash-in or wash-out parameters. Different weighting of false-negative vs false-positive calls allowed formulation of a statistically based interpretation scheme yielding optimized rules for the highest possible sensitivity (specificity 30%), for moderate (50%) or high (64-71%) specificity. The sensitivities obtained at the above specificity levels were better at 1.0 T (98, 97, or 96%) than at 1.5 T (96, 93, 86%). Using a widely available standardized MR technique definition of statistically founded interpretation rules is possible. Choice of an optimum interpretation rule may vary with the clinical question. Prospective testing remains necessary. Differences of 1.0 and 1.5 T are not statistically significant but may be due to pulse sequences.
开展了一项多中心研究，以提供改进动态对比增强磁共振成像（MRI）标准化及优化解读指南的基础。仅纳入计划对临床或影像异常进行活检的患者。他们在使用0.2 mmol钆喷酸葡胺/千克标准化团注前及之后五次，采用三维快速低角度激发（FLASH；87秒）序列，在西门子1.0 T（163个有效病变≥5毫米）或1.5 T（395个有效病变≥5毫米）设备上接受标准化动态MRI检查。使用判别分析分别对1.0 T和1.5 T数据进行分析。仅组织学相关病变纳入统计评估。组织病理学与影像学进行回顾性及开放性对照。通过组合多达五个流入或流出参数可获得最佳结果。对假阴性与假阳性判断进行不同加权，从而制定基于统计学的解读方案，得出针对最高可能敏感度（特异性30%）、中等（50%）或高（64 - 71%）特异性的优化规则。在上述特异性水平下获得的敏感度在1.0 T（98%、97%或96%）时优于1.5 T（96%、93%、86%）。使用广泛可用的标准化MR技术来定义基于统计学的解读规则是可行的。最佳解读规则的选择可能因临床问题而异。前瞻性测试仍有必要。1.0 T和1.5 T之间的差异无统计学意义，但可能与脉冲序列有关。
