Radiology, National Jewish Health, Denver, CO, United States.
Eur J Radiol. 2013 Dec;82(12):2378-85. doi: 10.1016/j.ejrad.2013.08.019. Epub 2013 Aug 30.
The purpose of this study was to determine the feasibility of proton MRI of the lung in sarcoidosis patients and the agreement between the imaging appearance of pulmonary sarcoidosis on MRI and CT.
Chest CT scans and dedicated pulmonary MRI scans (including HASTE, VIBE, and TrueFISP sequences) were performed within 90 days of each other in 29 patients. The scans were scored for gross parenchymal opacification, reticulation, nodules, and masses using a 3-point lobar scale. Total and subset scores for corresponding MRI and CT scans were compared using the Spearman correlation test, Bland-Altman plots, and Cohen's quadratic-weighted kappa analysis. MRI scores were compared to CT by lobe and disease category, using percentage agreement, Spearman rank correlation, and Cohen's quadratic-weighted kappa.
The mean (± s.d.) time between MRI and CT scans was 33 ± 32 days. There was substantial correlation and agreement between total disease scoring on MRI and CT with a Spearman correlation coefficient of 0.774 (p<0.0001) and a Cohen's weighted kappa score of 0.646. Correlation and agreement were highest for gross parenchymal opacification (0.695, 0.528) and reticulation (0.609, 0.445), and lowest in the setting of nodules (0.501, 0.305). Agreement testing was not performed for mass scores due to low prevalence. Upper lobe scoring on MRI and CT demonstrated greater agreement compared to the lower lobes (average difference in Cohen's weighted kappa score of 0.112).
There is substantial correlation and agreement between MRI and CT in the scoring of pulmonary sarcoidosis, though MRI evaluation in the upper lobes may be more accurate than in the lower lobes.
本研究旨在确定在结节病患者中进行质子 MRI 检查的可行性，以及 MRI 上肺部结节病的影像学表现与 CT 的一致性。
29 例患者在 90 天内分别进行胸部 CT 扫描和专用肺部 MRI 扫描（包括 HASTE、VIBE 和 TrueFISP 序列）。使用 3 分叶级评分系统对大体实质混浊、网状影、结节和肿块进行评分。使用 Spearman 相关检验、Bland-Altman 图和 Cohen 二次加权 kappa 分析比较相应 MRI 和 CT 扫描的总评分和亚组评分。通过叶和疾病类别比较 MRI 评分与 CT，使用百分比一致性、Spearman 秩相关和 Cohen 二次加权 kappa。
MRI 和 CT 之间的平均（±标准差）时间间隔为 33 ± 32 天。MRI 和 CT 上总疾病评分之间存在高度相关性和一致性，Spearman 相关系数为 0.774（p<0.0001），Cohen 加权 kappa 评分为 0.646。大体实质混浊（0.695，0.528）和网状影（0.609，0.445）的相关性和一致性最高，而结节（0.501，0.305）的相关性和一致性最低。由于结节评分的患病率较低，未进行一致性检验。与下叶相比，MRI 和 CT 上的上叶评分具有更高的一致性（Cohen 加权 kappa 评分的平均差异为 0.112）。
MRI 和 CT 在肺部结节病的评分中具有高度相关性和一致性，尽管上叶的 MRI 评估可能比下叶更准确。
