University of Sheffield, C Floor, Royal Hallamshire Hospital, Sheffield, England.
Radiology. 2012 May;263(2):569-77. doi: 10.1148/radiol.12110990. Epub 2012 Mar 6.
To evaluate the utility of 1.5-T noncontrast magnetic resonance (MR) imaging of the lung parenchyma and to compare it with computed tomography (CT) in the assessment of interstitial lung disease and other morphologic lung abnormalities.
Institutional review board approval was obtained for retrospective image analysis. A total of 236 patients who underwent MR imaging and CT as part of their assessment for suspected pulmonary hypertension were included in this study. Lung MR imaging was performed with a 1.5-T system as a stack of axial two-dimensional balanced steady-state free precession (bSSFP) acquisitions. Two radiologists independently evaluated CT and MR images for various morphologic abnormalities, such as pulmonary fibrosis, pleural and mediastinal disease, solid lesions, bronchial disease, and emphysema. Κ statistics were used to measure interobserver agreement.
Sensitivity and specificity of MR imaging in the identification of pulmonary fibrosis (n = 46) were 89% (95% confidence interval: 77%, 96%) and 91% (95% confidence interval: 76%, 98%), respectively, when compared with CT. In comparison to CT, MR imaging depicted 75% of ground-glass opacities. Nine of the 12 noncalcified nodules were identified on MR images. Lung nodules (75%, κ = 0.71) and effusions (100%, κ = 0.89) were also well visualized on MR images. MR imaging was however less effective in depicting emphysema (16%, κ = 0.60) and minor fibrosis (67%, κ = 0.79).
This study shows bSSFP MR imaging is inferior to CT in imaging parenchymal lung disease; however, this study does demonstrate for the first time a potential role for the bSSFP sequence as an alternative radiation-free noncontrast imaging modality for use in patients with pulmonary fibrosis.
评估肺部实质的 1.5-T 非对比磁共振（MR）成像的实用性，并将其与计算机断层扫描（CT）在评估间质性肺病和其他形态学肺部异常方面进行比较。
本回顾性图像分析获得了机构审查委员会的批准。本研究共纳入 236 例因疑似肺动脉高压而行 MR 成像和 CT 检查的患者。肺部 MR 成像采用 1.5-T 系统进行，作为轴向二维平衡稳态自由进动（bSSFP）采集的堆叠。两名放射科医生独立评估 CT 和 MR 图像的各种形态异常，如肺纤维化、胸膜和纵隔疾病、实体病变、支气管疾病和肺气肿。使用κ统计量来衡量观察者间的一致性。
MR 成像在识别（n = 46）肺纤维化方面的敏感性和特异性分别为 89%（95%置信区间：77%，96%）和 91%（95%置信区间：76%，98%），与 CT 相比。与 CT 相比，MR 成像显示 75%的磨玻璃密度影。12 个非钙化结节中有 9 个在 MR 图像上被识别。MR 成像还能很好地显示肺结节（75%，κ=0.71）和胸腔积液（100%，κ=0.89）。然而，MR 成像在显示肺气肿（16%，κ=0.60）和轻度纤维化（67%，κ=0.79）方面效果较差。
本研究表明 bSSFP MR 成像在成像肺部实质疾病方面不如 CT，但本研究首次证明了 bSSFP 序列作为一种替代辐射的非对比成像方式，在肺纤维化患者中具有潜在的应用价值。
