Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
J Magn Reson Imaging. 2012 Mar;35(3):537-42. doi: 10.1002/jmri.22847. Epub 2011 Nov 1.
To evaluate the inter-rater agreement of cortical lesion detection using 7 Tesla (T) FLASH-T2 and 3T DIR sequences.
Twenty-six patients with multiple sclerosis were scanned on a human 7T (Siemens) and 3T MRI (TIM Trio, Siemens) to acquire 3T DIR/MEMPR and 7T FLASH-T2 sequences. Four independent reviewers scored and categorized cortical lesions in the bilateral precentral gyri (motor strips) as leukocortical, intracortical, or subpial. Inter-rater agreement was assessed according to lesion category using the kappa statistic. The sensitivity of recent MAGNIMS consensus guidelines for cortical lesion detection using 3T DIR was assessed with 7T FLASH-T2 as the reference gold standard.
Inter-rater agreement at 7T was excellent compared with 3T (k = 0.97 versus 0.12). FLASH-T2 at 7T detected subpial lesions while 3T DIR did not. The predicted sensitivity of 3T DIR sequence for cortical lesions in vivo is modest (range of 13.6 to 18.3%).
The 7T FLASH-T2 detects more cortical-particularly subpial-lesions compared with 3T DIR. In the absence of DIR/postmortem data, 7T FLASH-T2 is a suitable gold-standard instrument and should be incorporated into future consensus guidelines.
评估使用 7 特斯拉（T）FLASH-T2 和 3T DIR 序列检测皮质病变的观察者间一致性。
26 例多发性硬化症患者在一台 7T（西门子）和 3T MRI（TIM Trio，西门子）上进行扫描，以获取 3T DIR/MEMPR 和 7T FLASH-T2 序列。四名独立的观察者对双侧中央前回（运动带）的皮质病变进行评分和分类，分为白质皮质、皮质内或皮质下病变。根据病变类别，使用kappa 统计评估观察者间的一致性。使用 7T FLASH-T2 作为参考金标准，评估 3T DIR 皮质病变检测的最新 MAGNIMS 共识指南的敏感性。
与 3T 相比，7T 的观察者间一致性极好（k = 0.97 对 0.12）。FLASH-T2 在 7T 时可检测到皮质下病变，而 3T DIR 则不能。3T DIR 序列对皮质病变的预测敏感性适中（范围为 13.6%至 18.3%）。
与 3T DIR 相比，7T FLASH-T2 可检测到更多的皮质病变，特别是皮质下病变。在缺乏 DIR/死后数据的情况下，7T FLASH-T2 是一种合适的金标准仪器，应纳入未来的共识指南。
