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门诊下呼吸道感染患者肺炎的胸部磁共振成像诊断。

Chest magnetic resonance imaging for pneumonia diagnosis in outpatients with lower respiratory tract infection.

机构信息

Dept of Infection Control, Oulu University Hospital, Oulu, Finland

These authors contributed equally to this work.

出版信息

Eur Respir J. 2017 Jan 11;49(1). doi: 10.1183/13993003.01303-2016. Print 2017 Jan.

Abstract

We assessed whether magnetic resonance imaging (MRI) is applicable for diagnosing pneumonia among adult outpatients with lower respiratory tract infection.Patients were recruited prospectively when they had symptoms for ≤7 days and fever ≥37.8 °C. The patients underwent high-resolution computed tomography (HRCT), MRI and chest radiography, which were repeated 1 month later if necessary, to verify pneumonia. The duration of MRI examination was 3-4 min.Among 77 patients, HRCT, MRI and radiography identified 32 (41.6%), 30 (39.0%) and 23 (29.9%) cases of pneumonia, respectively (p=0.001). MRI missed two HRCT-identified pneumonia cases due to motion artefacts. Chest radiography resulted in four false-positive pneumonia findings and MRI resulted in none. When HRCT was used as a reference, MRI had a sensitivity of 0.938 (95% CI 0.799-0.983) and specificity of 0.978 (95% CI 0.884-0.996) for the diagnosis of pneumonia, whereas the sensitivity and specificity for chest radiography were 0.719 (95% CI 0.546-0.844) and 0.911 (95% CI 0.793-0.965), respectively.MRI is an accurate, fast and effective method for diagnosing outpatient pneumonia, with better accuracy compared with chest radiography and almost similar accuracy compared with HRCT.

摘要

我们评估了磁共振成像(MRI)是否适用于诊断患有下呼吸道感染的成年门诊患者的肺炎。当患者出现症状≤7 天且体温≥37.8°C 时,前瞻性地招募患者。患者接受高分辨率计算机断层扫描(HRCT)、MRI 和胸部 X 线检查,如果有必要,1 个月后重复进行这些检查以验证肺炎。MRI 检查持续时间为 3-4 分钟。在 77 名患者中,HRCT、MRI 和 X 线分别确定了 32 例(41.6%)、30 例(39.0%)和 23 例(29.9%)肺炎(p=0.001)。由于运动伪影,MRI 漏诊了 2 例 HRCT 确定的肺炎病例。X 线检查导致 4 例假阳性肺炎发现,而 MRI 则没有。当 HRCT 作为参考时,MRI 对肺炎的诊断灵敏度为 0.938(95%CI 0.799-0.983),特异性为 0.978(95%CI 0.884-0.996),而 X 线检查的灵敏度和特异性分别为 0.719(95%CI 0.546-0.844)和 0.911(95%CI 0.793-0.965)。MRI 是一种准确、快速且有效的门诊肺炎诊断方法,其准确性优于 X 线检查,与 HRCT 几乎相当。

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