Mendichovszky I A, Cutajar M, Gordon I
Radiology and Physics Unit, University College London, Institute of Child Health, 30 Guilford Street, London WC1N1EH, UK.
Eur J Radiol. 2009 Sep;71(3):576-81. doi: 10.1016/j.ejrad.2008.09.025. Epub 2008 Nov 11.
The aim of this study was to investigate the maximum height, area under the curve (AUC) and full width at half maximum (FWHM) of the aortic input function (AIF) in renal dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) studies. We evaluated the significance of choice of size for regions of interest (ROI) in the aorta, reproducibility and inter-observer agreement of AIF measurements in healthy volunteers for renal DCE-MRI studies.
Fifteen healthy volunteers (nine males, six females), mean age 28.8 years (range 23-36 years), underwent two DCE-MRI kidney studies under similar conditions. Oblique-coronal DCE-MRI data volumes were acquired on a 1.5 T Siemens Avanto scanner with a 3D-FLASH pulse-sequence (TE/TR=0.53/1.63 ms, flip angle=17 degrees, acquisition matrix=128 x 104 voxels, strong fat saturation, PAT factor=2 (GRAPPA) and 400 mm x 325 mm FOV). Each dynamic dataset consisted of 18 slices of 7.5 mm thickness (no gap) and an in-plane resolution of 3.1 mm x 3.1 mm, acquired every 2.5 s for >5 min. During the MR scan a dose of 0.05 mmol (0.1 mL) kg(-1) body weight of dimeglumine gadopentetate (Magnevist) was injected intravenously (2 mL s(-1) injection rate), followed by a 15 mL saline flush at the same rate, using a MR-compatible automated injector (Spectris). For each DCE-MRI study two observers each drew two ROIs in the abdominal aorta. Both ROIs were 3 voxels in width and had the same inferior limit (just above the emergence of the renal arteries from the aorta) but had different heights (4 voxels for one ROI and 10 voxels for the other). The dimensions, position and time of drawing the ROIs in the dynamic study were standardised between observers prior to data analysis. Mean signal intensities measured in the ROIs were plotted over time, representing the AIF. For each study, AIF 1 was derived from ROI 1 and AIF 2 was derived from ROI 2.
Paired t-tests for inter-observer comparison on the pooled 30 DCE-MRI studies, showed good correlations (correlation coefficients >0.85) with no significant differences (p-values >0.82) when comparing the peak value, AUC and FWHM of the AIFs. Thus the results were operator independent. The size of the aortic ROIs significantly affected all measured parameters of the AIF (p-values <0.039). However, correlation coefficients when comparing AIF 1 and AIF 2 were high for all evaluated AIF parameters (correlation coefficients >0.88), indicating a similar shape and temporal dynamic of the passage of the contrast agent through the aorta. When comparing the intra-individual DCE-MRI studies for each volunteer all AIF parameters had p-values >0.22 and correlation coefficients <0.82, with the exception of the FWHM, which had a correlation coefficient of 0.96 showing a significant variation in AIF parameters in the same volunteer on different days.
本研究旨在探讨肾动态对比增强(DCE)磁共振成像(MRI)研究中主动脉输入函数(AIF)的最大高度、曲线下面积(AUC)和半高宽(FWHM)。我们评估了在肾DCE-MRI研究中,主动脉感兴趣区(ROI)大小选择的重要性、健康志愿者AIF测量的可重复性以及观察者间的一致性。
15名健康志愿者(9名男性,6名女性),平均年龄28.8岁(范围23 - 36岁),在相似条件下接受了两项DCE-MRI肾脏研究。在1.5T西门子Avanto扫描仪上,采用3D-FLASH脉冲序列(TE/TR = 0.53/1.63 ms,翻转角 = 17度,采集矩阵 = 128×104体素,强脂肪抑制,并行采集加速因子 = 2(GRAPPA),视野 = 400 mm×325 mm)获取斜冠状位DCE-MRI数据容积。每个动态数据集由18层厚度为7.5mm(无间隙)的切片组成,平面分辨率为3.1mm×3.1mm,每2.5s采集一次,持续超过5分钟。在磁共振扫描期间,静脉注射剂量为0.05mmol(0.1mL)kg⁻¹体重的钆喷酸葡胺(马根维显)(注射速率为2mL s⁻¹),随后以相同速率注射15mL生理盐水冲洗,使用与磁共振兼容的自动注射器(Spectris)。对于每项DCE-MRI研究,两名观察者分别在腹主动脉中绘制两个ROI。两个ROI宽度均为3个像素,下限相同(刚好在肾动脉从主动脉发出处上方),但高度不同(一个ROI为4个像素,另一个为10个像素)。在数据分析之前,观察者之间对动态研究中ROI的尺寸、位置和绘制时间进行了标准化。在ROI中测量的平均信号强度随时间绘制,代表AIF。对于每项研究,AIF 1来自ROI 1,AIF 2来自ROI 2。
在汇总的30项DCE-MRI研究中进行观察者间比较的配对t检验显示,在比较AIF的峰值、AUC和FWHM时,相关性良好(相关系数>0.85),无显著差异(p值>0.82)。因此,结果与操作者无关。主动脉ROI的大小显著影响AIF的所有测量参数(p值<0.039)。然而,在比较AIF 1和AIF 2时,所有评估的AIF参数的相关系数都很高(相关系数>0.88),表明造影剂通过主动脉的形状和时间动态相似。在比较每个志愿者的个体内DCE-MRI研究时,除FWHM外,所有AIF参数的p值>0.22,相关系数<0.82,FWHM的相关系数为0.96,表明同一志愿者在不同日期的AIF参数存在显著差异。