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免疫功能低下儿童肺部感染的磁共振成像:与多排螺旋计算机断层扫描的比较

Magnetic resonance imaging of pulmonary infection in immunocompromised children: comparison with multidetector computed tomography.

作者信息

Ozcan H Nursun, Gormez Ayşegul, Ozsurekci Yasemin, Karakaya Jale, Oguz Berna, Unal Sule, Cetin Mualla, Ceyhan Mehmet, Haliloglu Mithat

机构信息

Department of Radiology, Hacettepe University School of Medicine, Sihhiye, 06100, Ankara, Turkey.

Department of Pediatric Infectious Disease, Hacettepe University School of Medicine, Ankara, Turkey.

出版信息

Pediatr Radiol. 2017 Feb;47(2):146-153. doi: 10.1007/s00247-016-3729-1. Epub 2016 Oct 28.

Abstract

BACKGROUND

Computed tomography (CT) is commonly used to detect pulmonary infection in immunocompromised children.

OBJECTIVE

To compare MRI and multidetector CT findings of pulmonary abnormalities in immunocompromised children.

MATERIALS AND METHODS

Seventeen neutropaenic children (6 girls; ages 2-18 years) were included. Non-contrast-enhanced CT was performed with a 64-detector CT scanner. Axial and coronal non-enhanced thoracic MRI was performed using a 1.5-T scanner within 24 h of the CT examination (true fast imaging with steady-state free precession, fat-saturated T2-weighted turbo spin echo with motion correction, T2-weighted half-Fourier single-shot turbo spin echo [HASTE], fat-saturated T1-weighted spoiled gradient echo). Pulmonary abnormalities (nodules, consolidations, ground glass opacities, atelectasis, pleural effusion and lymph nodes) were evaluated and compared among MRI sequences and between MRI and CT. The relationship between MRI sequences and nodule sizes was examined by chi- square test.

RESULTS

Of 256 CT lesions, 207 (81%, 95% confidence interval [CI] 76-85%) were detected at MRI. Of 202 CT-detected nodules, 157 (78%, 95% CI 71-83%) were seen at motion-corrected MRI. Of the 1-5-mm nodules, 69% were detected by motion-corrected T2-weighted MRI and 38% by HASTE MRI.

CONCLUSION

Sensitivity of MRI (both axial fat-saturated T2-weighted turbo spin echo with variable phase encoding directions (BLADE) images and HASTE sequences) to detect pulmonary abnormalities is promising.

摘要

背景

计算机断层扫描(CT)常用于检测免疫功能低下儿童的肺部感染。

目的

比较免疫功能低下儿童肺部异常的MRI和多排CT表现。

材料与方法

纳入17例中性粒细胞减少症儿童(6名女孩;年龄2至18岁)。使用64排CT扫描仪进行非增强CT检查。在CT检查后24小时内,使用1.5-T扫描仪进行轴位和冠状位非增强胸部MRI检查(稳态自由进动真快速成像、带运动校正的脂肪饱和T2加权涡轮自旋回波、T2加权半傅里叶单次激发涡轮自旋回波[HASTE]、脂肪饱和T1加权扰相梯度回波)。对肺部异常(结节、实变、磨玻璃影、肺不张、胸腔积液和淋巴结)在MRI各序列之间以及MRI与CT之间进行评估和比较。通过卡方检验检查MRI序列与结节大小之间的关系。

结果

在256个CT病变中,MRI检测到207个(81%,95%置信区间[CI]76 - 85%)。在CT检测到的202个结节中,运动校正MRI上可见157个(78%,95%CI 71 - 83%)。在1 - 5毫米的结节中,69%可通过运动校正T加权MRI检测到,38%可通过HASTE MRI检测到。

结论

MRI(轴位脂肪饱和T2加权涡轮自旋回波可变相位编码方向[BLADE]图像和HASTE序列)检测肺部异常的敏感性很有前景。

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