基于 T 扰相的靶向快速膝关节 MRI 检查。
Targeted rapid knee MRI exam using T shuffling.
机构信息
Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, California, USA.
Global Applied Science Laboratory, GE Healthcare, Menlo Park, California, USA.
出版信息
J Magn Reson Imaging. 2019 Jun;49(7):e195-e204. doi: 10.1002/jmri.26600. Epub 2019 Jan 13.
BACKGROUND
MRI is commonly used to evaluate pediatric musculoskeletal pathologies, but same-day/near-term scheduling and short exams remain challenges.
PURPOSE
To investigate the feasibility of a targeted rapid pediatric knee MRI exam, with the goal of reducing cost and enabling same-day MRI access.
STUDY TYPE
A cost effectiveness study done prospectively.
SUBJECTS
Forty-seven pediatric patients.
FIELD STRENGTH/SEQUENCE: 3T. The 10-minute protocol was based on T Shuffling, a four-dimensional acquisition and reconstruction of images with variable T contrast, and a T 2D fast spin-echo (FSE) sequence. A distributed, compressed sensing-based reconstruction was implemented on a four-node high-performance compute cluster and integrated into the clinical workflow.
ASSESSMENT
In an Institutional Review Board-approved study with informed consent/assent, we implemented a targeted pediatric knee MRI exam for assessing pediatric knee pain. Pediatric patients were subselected for the exam based on insurance plan and clinical indication. Over a 2-year period, 47 subjects were recruited for the study and 49 MRIs were ordered. Date and time information was recorded for MRI referral, registration, and completion. Image quality was assessed from 0 (nondiagnostic) to 5 (outstanding) by two readers, and consensus was subsequently reached.
STATISTICAL TESTS
A Wilcoxon rank-sum test assessed the null hypothesis that the targeted exam times compared with conventional knee exam times were unchanged.
RESULTS
Of the 49 cases, 20 were completed on the same day as exam referral. Median time from registration to exam completion was 18.7 minutes. Median reconstruction time for T Shuffling was reduced from 18.9 minutes to 95 seconds using the distributed implementation. Technical fees charged for the targeted exam were one-third that of the routine clinical knee exam. No subject had to return for additional imaging.
DATA CONCLUSION
The targeted knee MRI exam is feasible and reduces the imaging time, cost, and barrier to same-day MRI access for pediatric patients.
LEVEL OF EVIDENCE
2 Technical Efficacy: Stage 6 J. Magn. Reson. Imaging 2019.
背景
磁共振成像（MRI）常用于评估儿科肌肉骨骼系统病变，但仍存在当天/近期预约和检查时间短的问题。
目的
研究一种靶向快速儿科膝关节 MRI 检查的可行性，以降低成本并实现当天进行 MRI 检查。
研究类型
前瞻性成本效益研究。
受试者
47 名儿科患者。
磁场强度/序列：3T。10 分钟的方案基于 T 扰相（T Shuffling），这是一种四维采集和重建图像的方法，可实现可变 T 对比，以及 T2D 快速自旋回波（FSE）序列。分布式基于压缩感知的重建在一个四核高性能计算集群上实现，并集成到临床工作流程中。
评估
在一项经机构审查委员会批准并获得知情同意/同意的研究中，我们实施了一种靶向儿科膝关节 MRI 检查，用于评估儿科膝关节疼痛。根据保险计划和临床指征，对儿科患者进行了该检查的选择。在两年的时间里，共招募了 47 名受试者，共进行了 49 次 MRI 检查。记录了 MRI 转诊、登记和完成的日期和时间信息。两位读者对图像质量进行了 0（无法诊断）至 5（出色）的评估，并随后达成共识。
统计学检验
Wilcoxon 秩和检验用于检验靶向检查时间与常规膝关节检查时间没有变化的零假设。
结果
在 49 例中，有 20 例在检查转诊当天完成。从登记到检查完成的中位数时间为 18.7 分钟。使用分布式实现，T Shuffling 的重建时间从 18.9 分钟减少到 95 秒。靶向膝关节 MRI 检查的技术费用是常规临床膝关节检查的三分之一。没有患者需要进行额外的影像学检查。
数据结论
靶向膝关节 MRI 检查是可行的，可以缩短成像时间、降低成本，并为儿科患者提供当天进行 MRI 检查的机会。
证据水平
2 技术效果：6 级 J. Magn. Reson. Imaging 2019.
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