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快速5分钟肩部MRI协议与标准肩部MRI协议的比较:一项多机构多阅片者研究

Comparison of a Fast 5-Minute Shoulder MRI Protocol With a Standard Shoulder MRI Protocol: A Multiinstitutional Multireader Study.

作者信息

Subhas Naveen, Benedick Alex, Obuchowski Nancy A, Polster Joshua M, Beltran Luis S, Schils Jean, Ciavarra Gina A, Gyftopoulos Soterios

机构信息

1 Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, A21, Cleveland, OH 44195.

2 School of Medicine, Case Western Reserve University, Cleveland, OH.

出版信息

AJR Am J Roentgenol. 2017 Apr;208(4):W146-W154. doi: 10.2214/AJR.16.17041. Epub 2017 Jan 31.

Abstract

OBJECTIVE

The purpose of this study was to compare the diagnostic performance of a 5-minute shoulder MRI protocol consisting of multiplanar 2D fast spin-echo (FSE) sequences with parallel imaging to that of a standard shoulder MRI protocol.

MATERIALS AND METHODS

A retrospective review of 151 3-T MRI examinations of shoulders of 147 patients (mean age, 46.95 years) and 50 1.5-T MRI examinations of shoulders of 50 patients (mean age, 53.74 years) with four fast and five standard sequences from two academic centers between January 2014 and April 2015 was performed by three musculoskeletal radiologists. Interchangeability of fast and standard MRI was tested by comparing interprotocol (fast vs standard) interreader agreement with standard MRI interreader agreement. Interreader agreement was also compared using kappa statistics. The frequency of major findings was compared using an adjusted McNemar test. Sensitivity and specificity of MRI were measured for 51 patients who underwent surgery.

RESULTS

Interprotocol reader agreement was essentially equal to reader agreement on standard MRI (mean difference ≤ 1%; 95% CI, -3.8% to 3.9%; 61-96% across structures). Interprotocol kappa values (0.373-0.645) were similar to standard MRI kappa values (0.320-0.726). Frequencies of major findings on fast and standard MRI were similar (0.7-19.6% across structures; p ≥ 0.08). Sensitivities of fast MRI for tendon and labral tears (33-92%) were equivalent or higher than those of standard MRI with similar specificities (77-98%).

CONCLUSION

Fast 5-minute shoulder MRI with multiplanar 2D FSE sequences using parallel imaging is interchangeable, with similar interreader agreement and accuracy, with standard shoulder MRI for evaluating shoulder injuries.

摘要

目的

本研究旨在比较由多平面二维快速自旋回波(FSE)序列及并行成像组成的5分钟肩部MRI协议与标准肩部MRI协议的诊断性能。

材料与方法

2014年1月至2015年4月期间,来自两个学术中心的三位肌肉骨骼放射科医生对147例患者(平均年龄46.95岁)的151次3-T肩部MRI检查以及50例患者(平均年龄53.74岁)的50次1.5-T肩部MRI检查进行了回顾性分析,这些检查采用了四个快速序列和五个标准序列。通过比较协议间(快速与标准)的阅片者一致性与标准MRI阅片者一致性来测试快速MRI和标准MRI的互换性。还使用kappa统计量比较阅片者一致性。使用校正的McNemar检验比较主要发现的频率。对51例接受手术的患者测量MRI的敏感性和特异性。

结果

协议间阅片者一致性基本等同于标准MRI的阅片者一致性(平均差异≤1%;95%可信区间,-3.8%至3.9%;各结构为61%-96%)。协议间kappa值(0.373 - 0.645)与标准MRI的kappa值(0.320 - 0.726)相似。快速MRI和标准MRI上主要发现的频率相似(各结构为0.7% - 19.6%;p≥0.08)。快速MRI对肌腱和盂唇撕裂的敏感性(33% - 92%)等同于或高于标准MRI,特异性相似(77% - 98%)。

结论

使用并行成像的多平面二维FSE序列进行的5分钟快速肩部MRI与标准肩部MRI在评估肩部损伤方面具有互换性,阅片者一致性和准确性相似。

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