慢性阻塞性肺疾病患者和健康志愿者动态 3D 相位分辨功能肺部（PREFUL）通气磁共振成像的可重复性。
Repeatability of dynamic 3D phase-resolved functional lung (PREFUL) ventilation MR Imaging in patients with chronic obstructive pulmonary disease and healthy volunteers.
机构信息
Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany.
Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany.
出版信息
J Magn Reson Imaging. 2021 Aug;54(2):618-629. doi: 10.1002/jmri.27543. Epub 2021 Feb 9.
BACKGROUND
A previous study has demonstrated the feasibility of 3D phase-resolved functional lung (PREFUL) MRI in healthy volunteers and patients with chronic pulmonary disease. Before clinical use, the repeatability of the ventilation parameters derived from 3D PREFUL MRI must be determined.
PURPOSE
To evaluate repeatability of 3D PREFUL and to compare with pulmonary functional lung testing (PFT).
STUDY TYPE
Prospective.
POPULATION
Fifty-three healthy subjects and 13 patients with chronic obstructive pulmonary disease (COPD).
FIELD STRENGTH/SEQUENCE: A prototype 3D stack-of-stars spoiled-gradient-echo sequence at 1.5 T.
ASSESSMENT
Study participants underwent repeated MRI examination (median time interval between scans COPD/healthy subjects [interquartile range]: 7/0 days [6-8/0-0 days]) and one PFT carried out at the time of the baseline MRI. For 3D PREFUL, regional ventilation (RVent) and flow-volume loops were computed and rated by cross-correlation (CC). Also, ventilation time-to-peak (VTTP) was computed. Ventilation defect percentage (VDP) maps were obtained for RVent and CC.
STATISTICAL TESTS
Repeatability of 3D PREFUL parameters was evaluated using Bland-Altman analysis, coefficient of variation (COV) and intraclass correlation coefficient (ICC). The relation between 3D PREFUL and PFT measures (forced expiratory volume in 1 second (FEV ) and forced vital capacity (FVC) was assessed using the Pearson correlation coefficient (r).
RESULTS
In healthy subjects and COPD patients, no significant bias (all P range: 0.09-0.77) and a moderate to good repeatability of RVent, VTTP, and VDP were found (COV range: 0.1%-18.2%, ICC range: 0.51-0.88). For CC and VDP moderate repeatability was found (COV range: 0.6%-43.6%, ICC: 0.38-0.60). CC, VDP , and VDP showed a good correlation with FEV (all |r| > 0.58, all P < 0.05) and FEV /FVC ratio (all |r| > 0.62, all P < 0.05).
DATA CONCLUSION
3D PREFUL provided a good repeatability of RVent, VTTP, and VDP and moderate repeatability of CC and VDP in healthy volunteers and COPD patients, and correlated well with FEV and FEV /FVC.
LEVEL OF EVIDENCE
2 TECHNICAL EFFICACY STAGE: 2.
背景
先前的研究已经证明了三维相位分辨功能肺（PREFUL）MRI 在健康志愿者和慢性肺部疾病患者中的可行性。在临床应用之前，必须确定从三维 PREFUL MRI 获得的通气参数的可重复性。
目的
评估三维 PREFUL 的可重复性，并与肺功能肺测试（PFT）进行比较。
研究类型
前瞻性。
人群
53 名健康受试者和 13 名慢性阻塞性肺疾病（COPD）患者。
磁场强度/序列：1.5T 原型三维星形扰相梯度回波序列。
评估
研究参与者接受了重复的 MRI 检查（COPD/健康受试者两次扫描之间的中位数时间间隔[四分位距]：7/0 天[6-8/0-0 天]），并在基线 MRI 时进行了一次 PFT。对于三维 PREFUL，计算了区域通气（RVent）和流量-容积环，并通过互相关（CC）进行了评分。还计算了通气达峰时间（VTTP）。为 Rvent 和 CC 获得了通气缺陷百分比（VDP）图。
统计学检验
使用 Bland-Altman 分析、变异系数（COV）和组内相关系数（ICC）评估三维 PREFUL 参数的可重复性。使用 Pearson 相关系数（r）评估三维 PREFUL 与 PFT 测量值（1 秒用力呼气量（FEV ）和用力肺活量（FVC）之间的关系。
结果
在健康受试者和 COPD 患者中，发现 RVent、VTTP 和 VDP 的无显著偏差（所有 P 值范围：0.09-0.77），且具有中等至良好的可重复性（COV 范围：0.1%-18.2%，ICC 范围：0.51-0.88）。对于 CC 和 VDP，发现具有中等的可重复性（COV 范围：0.6%-43.6%，ICC：0.38-0.60）。CC、VDP 和 VDP 与 FEV（所有 |r|>0.58，所有 P<0.05）和 FEV/FVC 比值（所有 |r|>0.62，所有 P<0.05）具有良好的相关性。
数据结论
三维 PREFUL 在健康志愿者和 COPD 患者中提供了 RVent、VTTP 和 VDP 的良好可重复性，以及 CC 和 VDP 的中等可重复性，并且与 FEV 和 FEV/FVC 具有良好的相关性。
证据水平
2 技术功效阶段：2。
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