Kim Jeongyun, Seo Nieun, Bae Heejin, Kang Eun Ae, Kim Eunju, Chung Yong Eun, Lim Joon-Seok, Kim Myeong-Jin
Department of Radiology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
AJR Am J Roentgenol. 2022 Apr;218(4):678-686. doi: 10.2214/AJR.21.26733. Epub 2021 Nov 3.
Long acquisition times for breath-hold contrast-enhanced (CE) T1-weighted imaging in MR enterography (MRE) protocols result in reduced image quality. The purpose of this study was to compare CE T1-weighted imaging performed using sensitivity encoding (SENSE) and compressed sensing-SENSE (CS-SENSE) in terms of image quality and diagnostic performance for active inflammation in Crohn disease (CD). This retrospective study included 41 patients (31 men, 10 women; mean age, 34 ± 12 [SD] years) who underwent MRE for known or suspected CD between June 2020 and September 2020. MRE was performed in one of two scanning rooms depending on scheduling availability. Per institutional protocol, in one room, the enteric phase was acquired using SENSE (acceleration factor, 3) and the portal phase was acquired using CS-SENSE (acceleration factor, 5); this order was reversed in the other room. Two radiologists independently assessed sequences for subjective image quality measures at the patient level and for active inflammation at the bowel-segment level. Mean image quality scores between readers were computed. Diagnostic performance for active inflammation was compared between SENSE and CS-SENSE using generalized estimating equations; a separate experienced radiologist reviewed the full MRE protocol to establish the reference standard. The mean acquisition time of CE T1-weighted imaging was 17.2 ± 1.1 seconds for SENSE versus 11.5 ± 0.8 seconds for CS-SENSE ( < .001). CS-SENSE scored significantly better than SENSE in overall image quality (4.2 ± 0.7 vs 3.7 ± 1.1; = .02), motion artifacts (4.0 ± 0.8 vs 3.6 ± 1.2; = .006), and aliasing artifacts (4.8 ± 0.4 vs 4.2 ± 0.6; < .001). CS-SENSE scored significantly worse than SENSE in synthetic appearance (4.6 ± 0.5 vs 4.8 ± 0.4; = .003). Contrast, sharpness, and blurring were not different between sequences (05). For reader 1, CS-SENSE, compared with SENSE, showed a sensitivity of 86% versus 81% ( = .09), specificity of 88% versus 83% ( = .08), and accuracy of 87% versus 82% ( = .56). For reader 2, CS-SENSE, compared with SENSE, showed a sensitivity of 92% versus 79% ( = .006), specificity of 90% versus 98% ( = .16), and accuracy of 91% versus 86% ( = .002). Use of CS-SENSE for CE T1-weighted imaging in MRE protocols results in reduced scan times with reduced artifact and improved image quality. The benefits of CS-SENSE in MRE protocols may improve the diagnostic performance for active inflammation in CD.
在磁共振小肠造影(MRE)协议中,屏气对比增强(CE)T1加权成像的采集时间较长,会导致图像质量下降。本研究的目的是比较使用敏感性编码(SENSE)和压缩感知-SENSE(CS-SENSE)进行的CE T1加权成像在克罗恩病(CD)活动性炎症的图像质量和诊断性能方面的差异。这项回顾性研究纳入了2020年6月至2020年9月期间因已知或疑似CD接受MRE检查的41例患者(31例男性,10例女性;平均年龄34±12[标准差]岁)。根据日程安排的可用性,MRE在两个扫描室之一进行。按照机构方案,在一个房间中,使用SENSE(加速因子为3)采集肠期图像,使用CS-SENSE(加速因子为5)采集门静脉期图像;在另一个房间中,顺序相反。两名放射科医生分别在患者层面评估序列的主观图像质量指标,并在肠段层面评估活动性炎症。计算读者之间的平均图像质量得分。使用广义估计方程比较SENSE和CS-SENSE在活动性炎症诊断性能方面的差异;另一位经验丰富的放射科医生审查了完整的MRE协议以建立参考标准。CE T1加权成像的平均采集时间,SENSE为17.2±1.1秒,而CS-SENSE为11.5±0.8秒(P<0.001)。CS-SENSE在整体图像质量(4.2±0.7对3.7±1.1;P=0.02)、运动伪影(4.0±0.8对3.6±1.2;P=0.006)和混叠伪影(4.8±0.4对4.2±0.6;P<0.001)方面的得分明显高于SENSE。CS-SENSE在合成外观方面的得分明显低于SENSE(4.6±0.5对4.8±0.4;P=0.003)。序列之间的对比度、锐度和模糊度没有差异(P>0.05)。对于读者1,与SENSE相比,CS-SENSE的敏感性为86%对81%(P=0.09),特异性为88%对83%(P=0.08),准确性为87%对82%(P=0.56)。对于读者2,与SENSE相比,CS-SENSE的敏感性为92%对79%(P=0.006),特异性为90%对98%(P=0.16),准确性为91%对86%(P=0.002)。在MRE协议中,将CS-SENSE用于CE T1加权成像可缩短扫描时间,减少伪影并提高图像质量。CS-SENSE在MRE协议中的优势可能会改善CD活动性炎症的诊断性能。