Department of Radiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
Department of Radiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
Eur J Radiol. 2019 Mar;112:207-213. doi: 10.1016/j.ejrad.2019.01.022. Epub 2019 Jan 22.
The aim of this study was to assess the feasibility of four-dimensional magnetic resonance imaging (4D MRI) at 3 T for the localization of parathyroid adenomas.
Preoperative 4D MRI scans, encompassing dynamic contrast-enhanced (DCE) sequences and non-contrast enhanced (non-CE) sequences, including a T2-weighted multipoint Dixon (T2-mDixon) sequence, with in-phase, out-phase, and water-only images, were evaluated retrospectively in 41 patients with surgically proven parathyroid lesions. Two readers who were blinded to the surgical findings independently reviewed the images in two sessions (non-CE sequences alone and non-CE + DCE sequences). The MRI localization of the suspected adenoma in each session and the consensus interpretation of the MRI images, were compared with the surgical results and interobserver agreement was assessed.
By interpreting the non-CE sequences alone, reader 1 correctly localized 34 parathyroid lesions (sensitivity 81.0%, positive predictive value (PPV) 87.2%), and reader 2 correctly localized 34 parathyroid lesions (sensitivity 81.0%, PPV 91.9%). With the addition of DCE sequences, reader 1 correctly identified 35 parathyroid lesions (sensitivity 83.3%, PPV 87.5%), while reader 2 correctly identified 36 parathyroid lesions (sensitivity 85.7%, PPV 92.3%). Overall, MRI detected 38 parathyroid lesions (sensitivity 90.5%, PPV 95.0%). Interobserver agreement was slightly superior in non-CE + DCE sequences compared to non-CE sequences alone (ĸ = 0.796 vs. ĸ = 0.738).
4D MRI with DCE sequencing is a reliable method for the localization of parathyroid adenomas.
本研究旨在评估 3T 四维磁共振成像（4D MRI）在甲状旁腺瘤定位中的可行性。
回顾性分析 41 例经手术证实的甲状旁腺病变患者的术前 4D MRI 扫描，包括动态对比增强（DCE）序列和非对比增强（non-CE）序列，包括 T2 加权多点 Dixon（T2-mDixon）序列，具有同相位、反相位和仅水图像。两位读者在两次会议中（仅非 CE 序列和非 CE+DCE 序列）对图像进行了独立评估，对可疑腺瘤的 MRI 定位和 MRI 图像的共识解读与手术结果进行了比较，并评估了观察者间的一致性。
通过单独解释非 CE 序列，读者 1 正确定位了 34 个甲状旁腺病变（灵敏度 81.0%，阳性预测值（PPV）87.2%），读者 2 正确定位了 34 个甲状旁腺病变（灵敏度 81.0%，PPV 91.9%）。加入 DCE 序列后，读者 1 正确识别了 35 个甲状旁腺病变（灵敏度 83.3%，PPV 87.5%），而读者 2 正确识别了 36 个甲状旁腺病变（灵敏度 85.7%，PPV 92.3%）。总体而言，MRI 检测到 38 个甲状旁腺病变（灵敏度 90.5%，PPV 95.0%）。与单独使用非 CE 序列相比，非 CE+DCE 序列的观察者间一致性略有提高（ĸ=0.796 比 ĸ=0.738）。
DCE 序列的 4D MRI 是甲状旁腺腺瘤定位的可靠方法。
