Scholz O, Denecke T, Böttcher J, Schwarz C, Mentzel H-J, Streitparth F, Maurer M H, Pfeil A, Huppertz A, Mehl A, Staab D, Hamm B, Renz D M
Department of Radiology, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany.
Institute of Diagnostic and Interventional Radiology, SRH Clinic Gera, Str. des Friedens 122, 07548 Gera, Germany.
Clin Radiol. 2017 Sep;72(9):754-763. doi: 10.1016/j.crad.2017.03.017. Epub 2017 May 22.
To evaluate different magnetic resonance imaging (MRI) sequences for diagnosis of pulmonary manifestations of cystic fibrosis (CF) in comparison to chest computed tomography (CT), including an extended outcome analysis.
Twenty-eight patients with CF (15 male, 13 female, mean age 30.5±9.4 years) underwent CT and MRI of the lung. MRI (1.5 T) included different T2- and T1-weighted sequences: breath-hold HASTE (half Fourier acquisition single shot turbo spin echo) and VIBE (volumetric interpolated breath-hold examination, before and after contrast medium administration) sequences and respiratory-triggered PROPELLER (periodically rotated overlapping parallel lines with enhanced reconstruction) sequences with and without fat signal suppression, and perfusion imaging. CT and MRI images were evaluated by the modified Helbich and the Eichinger scoring systems. The clinical follow-up analysis assessed pulmonary exacerbations within 24 months.
The highest concordance to CT was achieved for the PROPELLER sequences without fat signal suppression (concordance correlation coefficient CCC of the overall modified Helbich score 0.93 and of the overall Eichinger score 0.93). The other sequences had the following concordance: PROPELLER with fat signal suppression (CCCs 0.91 and 0.92), HASTE (CCCs 0.87 and 0.89), VIBE (CCCs 0.84 and 0.85) sequences. In the outcome analysis, the combined MRI analysis of all five sequences and a specific MRI protocol (PROPELLER without fast signal suppression, VIBE sequences, perfusion imaging) reached similar correlations to the number of pulmonary exacerbations as the CT examinations.
An optimum lung MRI protocol in patients with CF consists of PROPELLER sequences without fat signal suppression, VIBE sequences, and lung perfusion analysis to enable high diagnostic efficacy and outcome prediction.
与胸部计算机断层扫描（CT）相比，评估不同的磁共振成像（MRI）序列对囊性纤维化（CF）肺部表现的诊断价值，包括进行扩展的结果分析。
28例CF患者（15例男性，13例女性，平均年龄30.5±9.4岁）接受了肺部CT和MRI检查。MRI（1.5T）包括不同的T2加权和T1加权序列：屏气HASTE（半傅里叶采集单次激发快速自旋回波）和VIBE（容积内插屏气检查，在注射造影剂前后）序列，以及有或无脂肪信号抑制的呼吸触发PROPELLER（周期性旋转重叠平行线增强重建）序列，还有灌注成像。CT和MRI图像采用改良的Helbich评分系统和Eichinger评分系统进行评估。临床随访分析评估24个月内的肺部加重情况。
未进行脂肪信号抑制的PROPELLER序列与CT的一致性最高（总体改良Helbich评分的一致性相关系数CCC为0.93，总体Eichinger评分的CCC为0.93）。其他序列的一致性如下：进行脂肪信号抑制的PROPELLER序列（CCC分别为0.91和0.92）、HASTE序列（CCC分别为0.87和0.89）、VIBE序列（CCC分别为0.84和0.85）。在结果分析中，所有五个序列的联合MRI分析以及特定的MRI方案（未进行快速信号抑制的PROPELLER序列、VIBE序列、灌注成像）与肺部加重次数的相关性与CT检查相似。
CF患者的最佳肺部MRI方案包括未进行脂肪信号抑制的PROPELLER序列、VIBE序列和肺部灌注分析，以实现高诊断效能和结果预测。
