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应用磁敏感加权 MRI 评估颅内脑膜瘤相关性钙化。

Assessment of intracranial meningioma-associated calcifications using susceptibility-weighted MRI.

机构信息

Department of Radiology, Charité, Charitéplatz, Berlin, Germany.

Department of Radiology, Charité, Augustenburger Platz, Berlin, Germany.

出版信息

J Magn Reson Imaging. 2017 Oct;46(4):1177-1186. doi: 10.1002/jmri.25614. Epub 2017 Jan 20.

Abstract

PURPOSE

To determine the diagnostic accuracy of susceptibility-weighted MRI (SW-MRI) for the detection of intracranial meningioma-associated calcifications compared with standard MR sequences, using computed tomography (CT) as a reference standard.

MATERIALS AND METHODS

354 patients, who had received both a CT and a 1.5 Tesla clinical brain MRI with SW-MRI sequences between January 2014 and July 2016, were retrospectively evaluated and 316 patients were included. Calcification diameter was used to assess correlation between imaging modalities. Sensitivity and specificity as well as intra- and interobserver agreement were calculated for SW-MRI and standard MRI sequences when compared with reference standard CT.

RESULTS

Fifty patients had positive findings for intracranial meningioma-associated calcifications on CT scans. SW-MRI reached a sensitivity of 94% (95% confidence interval [CI]: 83-99%) and a specificity of 95% (95% CI: 92-98%) for the detection of meningioma-associated calcifications, while standard MRI yielded a sensitivity of 64% (95% CI: 49-77%) and a specificity of 94% (95% CI: 90-96%). Diameter measurements between SW-MRI and CT showed a close correlation (R  = 0.99; P < 0.001) with a slight overestimation of size, which, however, did not reach significance level (SW-MRI: 8.2 mm ± 7.1; CT: 6.8 mm ± 6.4; P = 0.29). Compared with standard MRI, SW-MRI showed a better interobserver agreement for size measurements of calcifications.

CONCLUSION

SW-MRI enables a reliable detection of intracranial meningioma-associated calcifications by using CT as a reference and offers a higher diagnostic accuracy than standard MRI.

LEVEL OF EVIDENCE

3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1177-1186.

摘要

目的

使用计算机断层扫描(CT)作为参考标准,确定对比常规磁共振序列,磁化率加权成像(SW-MRI)检测颅内脑膜瘤相关钙化的诊断准确性。

材料与方法

回顾性分析了 2014 年 1 月至 2016 年 7 月间 354 例同时接受 CT 和 1.5T 临床脑部 MRI 加 SW-MRI 序列检查的患者,其中 316 例患者纳入本研究。采用钙化直径评估不同成像方式间的相关性。比较 CT 参考标准后,计算 SW-MRI 和常规 MRI 序列的敏感性、特异性以及观察者内和观察者间的一致性。

结果

50 例患者 CT 扫描显示颅内脑膜瘤相关钙化阳性。SW-MRI 检测脑膜瘤相关钙化的敏感性为 94%(95%置信区间[CI]:83-99%),特异性为 95%(95%CI:92-98%),而常规 MRI 的敏感性为 64%(95%CI:49-77%),特异性为 94%(95%CI:90-96%)。SW-MRI 与 CT 之间的直径测量值具有密切相关性(R=0.99;P<0.001),且 SW-MRI 对钙化的大小存在轻微高估,但无统计学意义(SW-MRI:8.2mm±7.1;CT:6.8mm±6.4;P=0.29)。与常规 MRI 相比,SW-MRI 对钙化大小的观察者间一致性更好。

结论

SW-MRI 可以可靠地检测颅内脑膜瘤相关钙化,以 CT 作为参考,其诊断准确性优于常规 MRI。

证据水平

3 级 技术功效:2 级 J. 磁共振成像 2017;46:1177-1186.

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