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儿童放射学中肺部磁共振成像的现状和进一步展望。

The current status and further prospects for lung magnetic resonance imaging in pediatric radiology.

机构信息

Department of Pediatric Radiology, University of Leipzig, Liebigstraße 20a, 04103, Leipzig, Germany.

Institute for Diagnostic and Interventional Radiology, Hannover Medical School, 30625, Hannover, Germany.

出版信息

Pediatr Radiol. 2020 May;50(5):734-749. doi: 10.1007/s00247-019-04594-z. Epub 2020 Jan 29.

Abstract

Lung MRI makes it possible to replace up to 90% of CT examinations with radiation-free magnetic resonance diagnostics of the lungs without suffering any diagnostic loss. The individual radiation exposure can thus be relevantly reduced. This applies in particular to children who repeatedly require sectional imaging of the lung, e.g., in tumor surveillance or in chronic lung diseases such as cystic fibrosis. In this paper we discuss various factors that favor the establishment of lung MRI in the clinical setting. Among the many sequences proposed for lung imaging, respiration-triggered T2-W turbo spin-echo (TSE) sequences have been established as a good standard for children. Additional sequences are mostly dispensable. The most important pulmonary findings are demonstrated here in the form of a detailed pictorial essay. T1-weighted gradient echo sequences with ultrashort echo time are a new option. These sequences anticipate signal loss in the lung and deliver CT-like images with high spatial resolution. When using self-gated T1-W ultrashort echo time 3-D sequences that acquire iso-voxel geometry in the sub-millimeter range, secondary reconstructions are possible.

摘要

肺部 MRI 使得在不影响诊断质量的情况下,用无辐射的磁共振肺部诊断替代高达 90%的 CT 检查成为可能。因此,个体的辐射暴露可以得到显著降低。这尤其适用于那些需要反复进行肺部断层成像的儿童,例如在肿瘤监测或囊性纤维化等慢性肺部疾病的治疗中。在本文中,我们讨论了支持肺部 MRI 在临床环境中建立的各种因素。在为肺部成像提出的众多序列中,呼吸触发的 T2-W 涡轮自旋回波(TSE)序列已被确立为儿童的良好标准。其他序列大多是可有可无的。这里以详细的图片文章形式展示了最重要的肺部发现。具有超短回波时间的 T1 加权梯度回波序列是一种新的选择。这些序列可以预测肺部的信号丢失,并提供具有高空间分辨率的类似 CT 的图像。使用自门控 T1-W 超短回波时间 3D 序列,可以在亚毫米范围内获得等体素几何形状的采集,从而进行二次重建。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af13/7150663/d7d6bc3f22c0/247_2019_4594_Fig1_HTML.jpg

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