Merlini Laura, Carpentier Marc, Ferrey Solène, Anooshiravani Mehrak, Poletti Pierre-Alexandre, Hanquinet Sylviane
Department of Radiology, Unit of Pediatric Radiology, University Hospital Rue Willy-Donzé 6, 1205 Geneva, Switzerland.
Department of Epidemiology, University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva Switzerland.
Eur J Radiol. 2017 Mar;88:155-162. doi: 10.1016/j.ejrad.2017.01.014. Epub 2017 Jan 17.
To test the performance of a single 3D IR T2-Weighted sequence compared to a Whole-body MRI protocol including DWI, T1-Weighted and STIR 3D IR (3S) in a pediatric population.
Two radiologists (15 and 30 years of experience),reviewed WBMRIs: first the STIR alone and 2 weeks later the 3S protocol. The indications were variable. Only positive findings were explicitly reported. A third reader compared the results to gold standard (GS) exams specific for the pathology. Agreement between the two readers, sensitivity and positive predictive value of STIR were calculated.
fifty-four WBMRIs were included (16 suspected child abuse, 8 chronic recurrent multifocal osteomyelitis (CRMO), 11 lymphomas, 4 osteosarcomas, 9 neuroblastomas, 6 histiocytosis). The mean age was 6 years 10 months, range: 1 month to 15 years. Agreement between readers was of 0.87 [0.82-0.91] for 3D STIR, and 0.89 [0.83-0.93] for the 3S protocol. For reader 1 sensitivity of 3D STIR was 81.6% and of 3S 81.0%. For reader 2 it was 74.1% for 3D STIR and 74.7% for 3S. For both readers and for both protocols, the positive predictive value (PPV) depended on the type of disease (for example 100% histocytosis and osteosarcomas, >90% for child abuse, >85% CRMO but <70% for lymphoma and neuroblastoma).
Sensitivities were not different between the 2 protocols, for each reader and were different between the 2 readers for each protocol.
比较单一的三维反转恢复（IR）T2加权序列与包含弥散加权成像（DWI）、T1加权及短TI反转恢复（STIR）三维IR（3S）的全身磁共振成像（MRI）方案在儿科人群中的表现。
两位放射科医生（分别有15年和30年经验）对全身MRI进行阅片：首先单独阅STIR序列，两周后阅3S方案。检查指征各不相同。仅明确报告阳性结果。第三位阅片者将结果与针对该病理的金标准（GS）检查进行比较。计算两位阅片者之间的一致性、STIR的敏感性和阳性预测值。
纳入54例全身MRI（16例疑似虐待儿童、8例慢性复发性多灶性骨髓炎（CRMO）、11例淋巴瘤、4例骨肉瘤、9例神经母细胞瘤、6例组织细胞增多症）。平均年龄为6岁10个月，范围：1个月至15岁。两位阅片者之间，三维STIR的一致性为0.87[0.82 - 0.91]，3S方案为0.89[0.83 - 0.93]。对于阅片者1，三维STIR的敏感性为81.6%，3S为81.0%。对于阅片者2，三维STIR为74.1%，3S为74.7%。对于两位阅片者和两种方案，阳性预测值（PPV）取决于疾病类型（例如组织细胞增多症和骨肉瘤为100%，虐待儿童>90%，CRMO>85%但淋巴瘤和神经母细胞瘤<70%）。
对于每位阅片者，两种方案的敏感性无差异；对于每种方案，两位阅片者的敏感性存在差异。
