Andreou Adrian, Sohaib Aslam, Collins David J, Takahara Taro, Kwee Thomas C, Leach Martin O, MacVicar David A, Koh Dow-Mu
Department of Radiology, Royal Marsden, Sutton, Surrey, UK.
CR UK Clinical Magnetic Resonance Research Group, Institute of Cancer Research, Sutton, Surrey, UK.
Cancer Imaging. 2015 May 2;15(1):6. doi: 10.1186/s40644-015-0041-5.
To evaluate diffusion-weighted MR neurography (DW-MRN) for visualizing the brachial plexus and for the assessment of brachial plexopathy.
40 oncological patients with symptoms of brachial plexopathy underwent 1.5 T MRI using conventional MR sequences and unidirectional DW-MRN. The images were independently reviewed by two radiologists. Anatomic visualization of the brachial plexus was scored using a 5 point scale on conventional MR sequences and then combined with DW-MRN. A brachial plexus abnormality was also scored using a 5 point scale and inter-observer agreement determined by kappa statistics. Diagnostic accuracy for brachial plexopathy assessed by conventional MRI alone versus conventional MRI combined with DW-MRN was compared by ROC analysis using reference standards.
DW-MRN significantly improved visualization of the brachial plexus compared with conventional MRI alone (P<0.001). When assessing brachial plexopathy, inter-observer agreement was moderate for conventional MRI (kappa=0.48) but good for conventional MRI with DW-MRN (kappa=0.62). DW-MRN combined with conventional MRI significantly improved diagnostic accuracy in one observer (P<0.05) but was similar in the other observer.
DW-MRN improved visualization of the brachial plexus. Combining DW-MRN with conventional MRI can improve inter-observer agreement and detection of brachial plexopathy in symptomatic oncological patients.
评估扩散加权磁共振神经成像（DW-MRN）用于可视化臂丛神经及评估臂丛神经病变的情况。
40例有臂丛神经病变症状的肿瘤患者接受了1.5T磁共振成像检查，使用传统磁共振序列和单向DW-MRN。图像由两名放射科医生独立评估。在传统磁共振序列上使用5分制对臂丛神经的解剖可视化进行评分，然后与DW-MRN相结合。臂丛神经异常也使用5分制进行评分，并通过kappa统计确定观察者间的一致性。使用参考标准通过ROC分析比较单独使用传统MRI与传统MRI联合DW-MRN评估臂丛神经病变的诊断准确性。
与单独使用传统MRI相比，DW-MRN显著改善了臂丛神经的可视化（P<0.001）。在评估臂丛神经病变时，传统MRI的观察者间一致性为中等（kappa=0.48），而传统MRI联合DW-MRN时为良好（kappa=0.62）。DW-MRN与传统MRI联合使用在一名观察者中显著提高了诊断准确性（P<0.05），但在另一名观察者中相似。
DW-MRN改善了臂丛神经的可视化。将DW-MRN与传统MRI相结合可以提高有症状肿瘤患者中观察者间的一致性以及臂丛神经病变的检测率。
