全身3.0T磁共振成像在淋巴瘤中的应用：霍奇金淋巴瘤和弥漫性大B细胞淋巴瘤分期中不同序列组合的比较
Whole Body 3.0 T Magnetic Resonance Imaging in Lymphomas: Comparison of Different Sequence Combinations for Staging Hodgkin's and Diffuse Large B Cell Lymphomas.
作者信息
Latifoltojar Arash, Duncan Mark K J, Klusmann Maria, Sidhu Harbir, Bainbridge Alan, Neriman Deena, Fraioli Francesco, Lambert Jonathan, Ardeshna Kirit M, Punwani Shonit
机构信息
Centre for Medical Imaging, University College London, 2nd Floor Charles Bell House, 43-45 Foley Street, London W1W 7TS, UK.
The Royal Marsden Hospital, Downs road, Sutton, Surrey SM2 5PT, UK.
出版信息
J Pers Med. 2020 Dec 16;10(4):284. doi: 10.3390/jpm10040284.
To investigate the diagnostic value of different whole-body magnetic resonance imaging (WB-MRI) protocols for staging Hodgkin and diffuse-large B-cell lymphomas (HL and DLBCL), twenty-two patients (M/F 12/10, median age 32, range 22-87, HL/DLBCL 14/8) underwent baseline WB-MRI and F-2-fluoro-2-deoxy-D-glucose (F-FDG) positron emission tomography (PET) fused with computed tomography (CT) scan F-FDG-PET-CT. The 3.0 T WB-MRI was performed using pre-contrast modified Dixon (mDixon), T2-weighted turbo-spin-echo (TSE), diffusion-weighted-imaging (DWI), dynamic-contrast-enhanced (DCE) liver/spleen, contrast-enhanced (CE) lung MRI and CE whole-body mDixon. WB-MRI scans were divided into: (1) "WB-MRI ": whole-body DWI + in-phase mDixon (2) "WB-MRI ": whole-body T2-TSE (3) "WB-MRI ": whole-body CE mDixon + DCE liver/spleen and CE lung mDixon (4) "WB-MRI All ": the entire protocol. Two radiologists evaluated WB-MRIs at random, independently and then in consensus. Two nuclear-medicine-physicians reviewed F-FDG PET-CT in consensus. An enhanced-reference-standard (ERS) was derived using all available baseline and follow-up imaging. The sensitivity and specificity of WB-MRI protocols for nodal and extra-nodal staging was derived against the ERS. Agreement between the WB-MRI protocols and the ERS for overall staging was assessed using kappa statistic. For consensus WB-MRI, the sensitivity and specificity for nodal staging were 75%, 98% for WB-MRI , 76%, 98% for WB-MRI , 83%, 99% for WB-MRI and 87%, 100% for WB-MRI . The sensitivity and specificity for extra-nodal staging were 67% 100% for WB-MRI , 89%, 100% for WB-MRI , 89%, 100% for WB-MRI and 100%, 100% for the WB-MRI . The consensus WB-MRI read had perfect agreement with the ERS for overall staging [kappa = 1.00 (95% CI: 1.00-1.00)]. The best diagnostic performance is achieved combining all available WB-MRI sequences.
为研究不同的全身磁共振成像（WB-MRI）方案对霍奇金淋巴瘤和弥漫性大B细胞淋巴瘤（HL和DLBCL）分期的诊断价值，22例患者（男/女12/10，中位年龄32岁，范围22 - 87岁，HL/DLBCL 14/8）接受了基线WB-MRI检查以及F-2-氟-2-脱氧-D-葡萄糖（F-FDG）正电子发射断层扫描（PET）与计算机断层扫描（CT）融合检查（F-FDG-PET-CT）。采用对比剂前改良狄克逊（mDixon）、T2加权快速自旋回波（TSE）、扩散加权成像（DWI）、动态对比增强（DCE）肝脏/脾脏、对比增强（CE）肺部MRI和CE全身mDixon进行3.0T WB-MRI检查。WB-MRI扫描分为：（1）“WB-MRI ”：全身DWI + 同相位mDixon；（2）“WB-MRI ”：全身T2-TSE；（3）“WB-MRI ”：全身CE mDixon + DCE肝脏/脾脏和CE肺部mDixon；（4）“WB-MRI All”：整个方案。两名放射科医生随机、独立地对WB-MRI进行评估，然后达成共识。两名核医学医师共同审查F-FDG PET-CT。使用所有可用的基线和随访影像得出增强参考标准（ERS）。针对ERS得出WB-MRI方案对淋巴结和结外分期的敏感性和特异性。使用kappa统计量评估WB-MRI方案与ERS在总体分期上的一致性。对于达成共识的WB-MRI，淋巴结分期的敏感性和特异性分别为：WB-MRI 为75%、98%，WB-MRI 为76%、98%，WB-MRI 为83%、99%，WB-MRI 为87%、100%。结外分期的敏感性和特异性分别为：WB-MRI 为67%、100%，WB-MRI 为89%、100%，WB-MRI 为89%、100%，WB-MRI 为100%、100%。达成共识的WB-MRI 解读在总体分期上与ERS具有完美一致性[kappa = 1.00（95%CI：1.00 - 1.00）]。结合所有可用的WB-MRI序列可获得最佳诊断性能。
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