From the School of Computer and Control Engineering, Yantai University, Yantai, China (Q.Z.); Department of Radiology (M.I., Y.F.) and Center for Lymphatic Disorders (M.I.), Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, Richards Building, 7th Floor, Room D703, Philadelphia, PA 19104.
Radiology. 2020 Jul;296(1):202-207. doi: 10.1148/radiol.2020192337. Epub 2020 May 5.
Background Dynamic contrast material-enhanced MR lymphangiography has recently emerged as a technique to image the lymphatic anatomy and identify lymphatic flow abnormalities; however, a method to quantify lymphatic flow in health and disease is needed. Purpose To develop a method to quantify thoracic lymphatic flow patterns using dynamic contrast-enhanced MR lymphangiography. Materials and Methods The following patients with dynamic contrast-enhanced MR lymphangiography images collected in 2015 and 2016 were retrospectively identified: group A, neonates with chylothorax; group B, children with heart failure complicated by plastic bronchitis; and group C, adults with lymphatic plastic bronchitis and without heart failure. An automated image segmentation method was developed for segmenting the contrast-enhanced lymphatic flow in spatiotemporal domains from the dynamic contrast-enhanced MR lymphangiography images. The lymphatic flow rates were quantified for individual patients on the basis of their spatiotemporal dynamic contrast-enhanced MR lymphangiography segmentation results, and the flow rates were compared among the three patient groups by using Wilcoxon rank sum tests. Results Twenty-two patients were evaluated: seven neonates (mean age, 49 days ± 71 [standard deviation]; three boys, four girls), 10 children (mean age, 8 years ± 3; seven boys, three girls), and five adults (mean age, 46 years ± 10; three men, two women). The proposed method was used to obtain lymphatic flow segmentation results with Dice scores of 0.80, 0.82, and 0.83 for patients from groups A, B, and C, respectively. The mean flow rates for groups A, B, and C were 1.8 mL/min ± 1.4, 4.0 mL/min ± 1.8, and 12.5 mL/min ± 3.8, respectively. The flow rate differed significantly between groups A and B ( = .002), groups A and C ( = .01), and groups B and C ( = .01). Conclusion An automatic spatiotemporal segmentation method was used to determine thoracic lymphatic flow rates in individual patients based on their dynamic contrast-enhanced MR lymphangiographic images. © RSNA, 2020
背景 动态对比增强磁共振淋巴管成像最近已成为一种成像淋巴管解剖结构和识别淋巴流动异常的技术；然而，需要一种方法来量化健康和疾病中的淋巴流量。目的 开发一种使用动态对比增强磁共振淋巴管成像定量胸导管流量模式的方法。材料与方法 回顾性地确定了 2015 年和 2016 年收集的动态对比增强磁共振淋巴管成像图像的以下患者：A 组，乳糜胸新生儿；B 组，心力衰竭合并塑型性支气管炎的儿童；C 组，无心力衰竭的淋巴塑型性支气管炎成人。开发了一种自动图像分割方法，用于从动态对比增强磁共振淋巴管成像图像的时空域中分割增强的淋巴流。基于个体患者的时空动态对比增强磁共振淋巴管成像分割结果来量化每个患者的淋巴流量，并使用 Wilcoxon 秩和检验比较三组患者之间的流量。结果 对 22 例患者进行了评估：7 例新生儿（平均年龄，49 天±71[标准差]；3 例男，4 例女），10 例儿童（平均年龄，8 岁±3；7 例男，3 例女），5 例成人（平均年龄，46 岁±10；3 例男，2 例女）。该方法用于获得 A、B 和 C 组患者的淋巴管分割结果，Dice 评分分别为 0.80、0.82 和 0.83。A、B 和 C 组的平均流速分别为 1.8 毫升/分钟±1.4、4.0 毫升/分钟±1.8 和 12.5 毫升/分钟±3.8。A 组和 B 组（ =.002）、A 组和 C 组（ =.01）以及 B 组和 C 组（ =.01）之间的流速差异有统计学意义。结论 使用自动时空分割方法，根据个体患者的动态对比增强磁共振淋巴管成像图像确定胸导管流量。©RSNA，2020
