Sodhi Kushaljit Singh, Bhatia Anmol, Samujh Ram, Mathew Joseph L, Lee Edward Y
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India.
Department of Pediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
AJR Am J Roentgenol. 2019 May;212(5):982-987. doi: 10.2214/AJR.18.20928. Epub 2019 Feb 19.
The objective of our study was to prospectively investigate the diagnostic accuracy and added value of fast MRI for evaluating pulmonary hydatid disease in children by comparing fast MRI findings with MDCT findings. Twenty-eight consecutive children (24 boys and four girls; mean age ± SD, 8.93 ± 3.1 years; range, 5-17 years) with clinically suspected pulmonary hydatid disease were enrolled in this prospective research study for the period from October 2012 to July 2018. Fast MRI without contrast material and contrast-enhanced MDCT of the chest were performed within 48 hours of each other in all children. Two pediatric radiologists independently evaluated the lungs for the presence of consolidation, nodule, and mass (solid vs cyst). Cysts were further evaluated for the presence of fluid, air, and an internal membrane. The accuracies of fast MRI and MDCT for detecting pulmonary hydatid disease were obtained and compared. Interobserver agreement was measured with the kappa coefficient. The accuracy of fast MRI and MDCT for detecting pulmonary hydatid cyst was 92.86%. There was no difference between fast MRI and MDCT for accurately detecting pulmonary hydatid cyst ( < 0.001). Internal membranes were detected in 11 of 28 patients (39.28%) with fast MRI and three of 28 patients (10.71%) with MDCT. Almost perfect interobserver agreement was present between the two independent reviewers (κ = 1). Fast MRI without contrast material is comparable to contrast-enhanced MDCT for accurately detecting lung cysts in pediatric patients with pulmonary hydatid disease. However, fast MRI provides added diagnostic value by showing internal membranes of cysts, which is specific to pulmonary hydatid disease.
我们研究的目的是通过比较快速磁共振成像（fast MRI）与多层螺旋CT（MDCT）的表现，前瞻性地研究快速MRI对评估儿童肺包虫病的诊断准确性和附加价值。2012年10月至2018年7月期间，28例临床疑似肺包虫病的连续儿童（24例男孩和4例女孩；平均年龄±标准差，8.93±3.1岁；范围，5 - 17岁）纳入了这项前瞻性研究。所有儿童在48小时内先后进行了胸部无对比剂快速MRI和对比增强MDCT检查。两名儿科放射科医生独立评估肺部是否存在实变、结节和肿块（实性与囊性）。对囊肿进一步评估是否存在液体、空气和内部隔膜。获得并比较了快速MRI和MDCT检测肺包虫病的准确性。用kappa系数测量观察者间的一致性。快速MRI和MDCT检测肺包虫囊肿的准确性为92.86%。快速MRI和MDCT在准确检测肺包虫囊肿方面无差异（<0.001）。28例患者中有11例（39.28%）通过快速MRI检测到内部隔膜，28例患者中有3例（10.71%）通过MDCT检测到内部隔膜。两位独立 reviewers之间存在几乎完美的观察者间一致性（κ = 1）。无对比剂快速MRI在准确检测肺包虫病儿童患者的肺囊肿方面与对比增强MDCT相当。然而，快速MRI通过显示囊肿的内部隔膜提供了附加诊断价值，这是肺包虫病所特有的。
