多参数肾脏 MRI：一项受试者内测试-再测试重复性研究。
Multiparametric Renal MRI: An Intrasubject Test-Retest Repeatability Study.
机构信息
Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Department of Radiotherapy, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
出版信息
J Magn Reson Imaging. 2021 Mar;53(3):859-873. doi: 10.1002/jmri.27167. Epub 2020 Apr 16.
BACKGROUND
Renal multiparametric magnetic resonance imaging (MRI) is a promising tool for diagnosis, prognosis, and treatment monitoring in kidney disease.
PURPOSE
To determine intrasubject test-retest repeatability of renal MRI measurements.
STUDY TYPE
Prospective.
POPULATION
Nineteen healthy subjects aged over 40 years.
FIELD STRENGTH/SEQUENCES: T and T mapping, R * mapping or blood oxygenation level-dependent (BOLD) MRI, diffusion tensor imaging (DTI), and intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI), 2D phase contrast, arterial spin labelling (ASL), dynamic contrast enhanced (DCE) MRI, and quantitative Dixon for fat quantification at 3T.
ASSESSMENT
Subjects were scanned twice with ~1 week between visits. Total scan time was ~1 hour. Postprocessing included motion correction, semiautomated segmentation of cortex and medulla, and fitting of the appropriate signal model.
STATISTICAL TEST
To assess the repeatability, a Bland-Altman analysis was performed and coefficients of variation (CoVs), repeatability coefficients, and intraclass correlation coefficients were calculated.
RESULTS
CoVs for relaxometry (T , T , R */BOLD) were below 6.1%, with the lowest CoVs for T maps and highest for R */BOLD. CoVs for all diffusion analyses were below 7.2%, except for perfusion fraction (F ), with CoVs ranging from 18-24%. The CoV for renal sinus fat volume and percentage were both around 9%. Perfusion measurements were most repeatable with ASL (cortical perfusion only) and 2D phase contrast with CoVs of 10% and 13%, respectively. DCE perfusion had a CoV of 16%, while single kidney glomerular filtration rate (GFR) had a CoV of 13%. Repeatability coefficients (RCs) ranged from 7.7-87% (lowest/highest values for medullary mean diffusivity and cortical F , respectively) and intraclass correlation coefficients (ICCs) ranged from -0.01 to 0.98 (lowest/highest values for cortical F and renal sinus fat volume, respectively).
DATA CONCLUSION
CoVs of most MRI measures of renal function and structure (with the exception of F and perfusion as measured by DCE) were below 13%, which is comparable to standard clinical tests in nephrology.
LEVEL OF EVIDENCE
2 TECHNICAL EFFICACY: Stage 1.
背景
肾脏多参数磁共振成像（MRI）是一种有前途的工具，可用于诊断、预后和治疗监测肾脏疾病。
目的
确定肾脏 MRI 测量的受试者内测试-再测试可重复性。
研究类型
前瞻性。
人群
19 名年龄在 40 岁以上的健康受试者。
磁场强度/序列：T 和 T 映射、R *映射或血氧水平依赖（BOLD）MRI、扩散张量成像（DTI）和体素内不相干运动（IVIM）扩散加权成像（DWI）、二维相位对比、动脉自旋标记（ASL）、动态对比增强（DCE）MRI 和定量 Dixon 用于 3T 下的脂肪定量。
评估
受试者在两次就诊之间间隔约 1 周进行扫描。总扫描时间约为 1 小时。后处理包括运动校正、皮质和髓质的半自动分割以及适当信号模型的拟合。
统计检验
为了评估可重复性，进行了 Bland-Altman 分析，并计算了变异系数（CoV）、重复性系数和组内相关系数。
结果
弛豫率（T 、T 、R */BOLD）的 CoV 低于 6.1%，T 图的 CoV 最低，R */BOLD 的 CoV 最高。所有扩散分析的 CoV 均低于 7.2%，除灌注分数（F ）外，CoV 范围为 18-24%。肾窦脂肪体积和百分比的 CoV 均约为 9%。灌注测量最可重复，ASL（仅皮质灌注）和二维相位对比的 CoV 分别为 10%和 13%。DCE 灌注的 CoV 为 16%，而单肾肾小球滤过率（GFR）的 CoV 为 13%。重复性系数（RC）范围为 7.7-87%（最低/最高值分别为髓质平均扩散率和皮质 F ），组内相关系数（ICC）范围为-0.01-0.98（最低/最高值分别为皮质 F 和肾窦脂肪体积）。
数据结论
大多数肾脏功能和结构的 MRI 测量指标的 CoV（除外 DCE 测量的 F 和灌注）均低于 13%，与肾脏病学中的标准临床测试相当。
证据水平
2 技术功效：阶段 1。
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