Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
Department of Orthopaedics, Bart's Health NHS Trust, London, UK.
Skeletal Radiol. 2021 Jun;50(6):1209-1218. doi: 10.1007/s00256-020-03663-x. Epub 2020 Nov 16.
The objective of this study is to compare T1-weighted gradient echo (T1W GrE: control technique) chemical shift imaging (CSI) with T2-weighted fast spin echo (T2W FSE: experimental technique) CSI for differentiating non-neoplastic and neoplastic marrow lesions.
Patients undergoing MRI for various marrow lesions were investigated with T1W GrE and T2W FSE Dixon CSI. Signal intensity (SI) change between in-phase (IP) and opposed-phase (OP) sequences was calculated, and SI drop > 20% considered to represent non-neoplastic lesions while SI drop < 20% considered to represent neoplastic lesions. Final diagnosis was based on imaging features (n = 42) or histology (n = 43) and classified as non-neoplastic, benign neoplastic, and malignant neoplastic. Inter-observer and inter-technique agreement between 2 readers was calculated.
The study included 85 patients (44 males and 41 females; mean age 41.1 years, range 2-83 years). Final diagnosis included 19 (22.4%) non-neoplastic lesions, 27 (31.8%) benign neoplasms, and 39 (45.9%) malignant neoplasms. On T1W GrE CSI, 19-21 lesions were classed as non-neoplastic and 64-66 as neoplastic, while on T2W FSE Dixon CSI, 22-24 lesions were classed as non-neoplastic and 61-64 as neoplastic. Lesion classification matched between the 2 techniques in 91.8-96.5% of cases. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of T1W GrE CSI for differentiating non-neoplastic and neoplastic marrow lesions were 66.7-72.2%, 88.1-89.6%, 61.9-63.2%, 90.9-92.2%, and 84.7%, and of T2W FSE Dixon CSI were 72.2-77.8%, 85.1-86.6%, 58.3-59.1%, 92.1-93.4%, and 83.5%.
T1W GrE CSI and T2W FSE Dixon CSI produce similar results in the assessment of non-neoplastic and neoplastic marrow lesions.
本研究旨在比较 T1 加权梯度回波（T1W GrE：对照技术）化学位移成像（CSI）与 T2 加权快速自旋回波（T2W FSE：实验技术）CSI，以区分非肿瘤性和肿瘤性骨髓病变。
对因各种骨髓病变而行 MRI 检查的患者行 T1W GrE 和 T2W FSE Dixon CSI。计算同相位（IP）和反相位（OP）序列之间的信号强度（SI）变化，SI 下降>20% 认为代表非肿瘤性病变，而 SI 下降<20% 认为代表肿瘤性病变。最终诊断基于影像学特征（n=42）或组织学（n=43），并分为非肿瘤性、良性肿瘤性和恶性肿瘤性。由 2 位观察者计算观察者间和技术间的一致性。
该研究纳入 85 例患者（44 例男性和 41 例女性；平均年龄 41.1 岁，范围 2-83 岁）。最终诊断包括 19 例（22.4%）非肿瘤性病变、27 例（31.8%）良性肿瘤和 39 例（45.9%）恶性肿瘤。在 T1W GrE CSI 上，19-21 例病变被归类为非肿瘤性，64-66 例病变被归类为肿瘤性，而在 T2W FSE Dixon CSI 上，22-24 例病变被归类为非肿瘤性，61-64 例病变被归类为肿瘤性。两种技术的病变分类在 91.8%-96.5%的病例中相匹配。T1W GrE CSI 用于区分非肿瘤性和肿瘤性骨髓病变的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 66.7%-72.2%、88.1%-89.6%、61.9%-63.2%、90.9%-92.2%和 84.7%，T2W FSE Dixon CSI 的相应值分别为 72.2%-77.8%、85.1%-86.6%、58.3%-59.1%、92.1%-93.4%和 83.5%。
T1W GrE CSI 和 T2W FSE Dixon CSI 在评估非肿瘤性和肿瘤性骨髓病变方面产生相似的结果。
