用于非小细胞肺癌患者术后肺功能预测的3D心电图和呼吸门控非对比增强（CE）灌注磁共振成像：与薄层定量计算机断层扫描、动态CE灌注磁共振成像和灌注扫描的比较
3D ECG- and respiratory-gated non-contrast-enhanced (CE) perfusion MRI for postoperative lung function prediction in non-small-cell lung cancer patients: A comparison with thin-section quantitative computed tomography, dynamic CE-perfusion MRI, and perfusion scan.
作者信息
Ohno Yoshiharu, Seki Shinichiro, Koyama Hisanobu, Yoshikawa Takeshi, Matsumoto Sumiaki, Takenaka Daisuke, Kassai Yoshimori, Yui Masao, Sugimura Kazuro
机构信息
Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Japan.
Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
出版信息
J Magn Reson Imaging. 2015 Aug;42(2):340-53. doi: 10.1002/jmri.24800. Epub 2014 Nov 19.
PURPOSE
To compare predictive capabilities of non-contrast-enhanced (CE)- and dynamic CE-perfusion MRIs, thin-section multidetector computed tomography (CT) (MDCT), and perfusion scan for postoperative lung function in non-small cell lung cancer (NSCLC) patients.
MATERIALS AND METHODS
Sixty consecutive pathologically diagnosed NSCLC patients were included and prospectively underwent thin-section MDCT, non-CE-, and dynamic CE-perfusion MRIs and perfusion scan, and had their pre- and postoperative forced expiratory volume in one second (FEV1 ) measured. Postoperative percent FEV1 (po%FEV1 ) was then predicted from the fractional lung volume determined on semiquantitatively assessed non-CE- and dynamic CE-perfusion MRIs, from the functional lung volumes determined on quantitative CT, from the number of segments observed on qualitative CT, and from uptakes detected on perfusion scans within total and resected lungs. Predicted po%FEV1 s were then correlated with actual po%FEV1 s, which were %FEV1 s measured postoperatively. The limits of agreement were also determined.
RESULTS
All predicted po%FEV1 s showed significant correlation (0.73 ≤ r ≤ 0.93, P < 0.0001) and limits of agreement with actual po%FEV1 (non-CE-perfusion MRI: 0.3 ± 10.0%, dynamic CE-perfusion MRI: 1.0 ± 10.8%, perfusion scan: 2.2 ± 14.1%, quantitative CT: 1.2 ± 9.0%, qualitative CT: 1.5 ± 10.2%).
CONCLUSION
Non-CE-perfusion MRI may be able to predict postoperative lung function more accurately than qualitatively assessed MDCT and perfusion scan.
目的
比较非增强（CE）和动态CE灌注MRI、薄层多排螺旋计算机断层扫描（CT）（MDCT）以及灌注扫描对非小细胞肺癌（NSCLC）患者术后肺功能的预测能力。
材料与方法
纳入60例经病理诊断的连续NSCLC患者，前瞻性地接受薄层MDCT、非CE和动态CE灌注MRI以及灌注扫描，并测量其术前和术后第一秒用力呼气量（FEV1）。然后，根据在半定量评估的非CE和动态CE灌注MRI上确定的肺体积分数、在定量CT上确定的功能性肺体积、在定性CT上观察到的节段数以及在全肺和切除肺内灌注扫描检测到的摄取量，预测术后FEV1百分比（po%FEV1）。然后将预测的po%FEV1与实际的po%FEV1（术后测量的%FEV1）进行相关性分析。还确定了一致性界限。
结果
所有预测的po%FEV1均显示出显著相关性（0.73≤r≤0.93，P<0.0001），且与实际po%FEV1的一致性界限如下（非CE灌注MRI：0.3±10.0%，动态CE灌注MRI：1.0±10.8%，灌注扫描：2.2±14.1%，定量CT：1.2±9.0%，定性CT：1.5±10.2%）。
结论
非CE灌注MRI可能比定性评估的MDCT和灌注扫描更能准确预测术后肺功能。
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