Wucherpfennig Lena, Triphan Simon Mf, Weinheimer Oliver, Eichinger Monika, Wege Sabine, Eberhardt Ralf, Puderbach Michael U, Kauczor Hans-Ulrich, Heussel Claus P, Heussel Gudula, Wielpütz Mark O
Department of Diagnostic and Interventional Radiology, Subdivision of Pulmonary Imaging, 27178University Hospital Heidelberg, Heidelberg, Germany.
Translational Lung Research Center Heidelberg (TLRC), German Lung Research Center (DZL), Heidelberg, Germany.
Acta Radiol. 2023 Mar;64(3):1038-1046. doi: 10.1177/02841851221111486. Epub 2022 Jul 25.
Recent studies support magnetic resonance angiography (MRA) as a diagnostic tool for pulmonary arterial disease.
To determine MRA image quality and reproducibility, and the dependence of MRA image quality and reproducibility on disease severity in patients with chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF).
Twenty patients with COPD (mean age 66.5 ± 8.9 years; FEV1% = 42.0 ± 13.3%) and 15 with CF (mean age 29.3 ± 9.3 years; FEV1% = 66.6 ± 15.8%) underwent morpho-functional chest magnetic resonance imaging (MRI) including time-resolved MRA twice one month apart (MRI1, MRI2), and COPD patients underwent non-contrast computed tomography (CT). Image quality was assessed visually using standardized subjective 5-point scales. Contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were measured by regions of interest. Disease severity was determined by spirometry, a well-evaluated chest MRI score, and by computational CT emphysema index (EI) for COPD.
Subjective image quality was diagnostic for all MRA at MRI1 and MRI2 (mean score = 4.7 ± 0.6). CNR and SNR were 4 43.8 ± 8.7 and 50.5 ± 8.7, respectively. Neither image quality score nor CNR or SNR correlated with FEV1% or chest MRI score for COPD and CF (r = 0.239-0.248). CNR and SNR did not change from MRI1 to MRI2 ( = 0.434-0.995). Further, insignificant differences in CNR and SNR between MRA at MRI1 and MRI2 did not correlate with FEV1% nor chest MRI score in COPD and CF (r = -0.238-0.183), nor with EI in COPD (r = 0.100-0.111).
MRA achieved diagnostic quality in COPD and CF patients and was highly reproducible irrespective of disease severity. This supports MRA as a robust alternative to CT in patients with underlying muco-obstructive lung disease.
近期研究支持将磁共振血管造影（MRA）作为诊断肺动脉疾病的工具。
确定慢性阻塞性肺疾病（COPD）和囊性纤维化（CF）患者的MRA图像质量和可重复性，以及MRA图像质量和可重复性对疾病严重程度的依赖性。
20例COPD患者（平均年龄66.5±8.9岁；第一秒用力呼气容积百分比（FEV1%）=42.0±13.3%）和15例CF患者（平均年龄29.3±9.3岁；FEV1%=66.6±15.8%）接受了形态功能胸部磁共振成像（MRI），包括时间分辨MRA，间隔1个月进行两次检查（MRI1、MRI2），COPD患者还接受了非增强计算机断层扫描（CT）。使用标准化的主观5分制量表对图像质量进行视觉评估。通过感兴趣区域测量对比噪声比（CNR）和信噪比（SNR）。通过肺活量测定、评估良好的胸部MRI评分以及COPD的计算机断层扫描肺气肿指数（EI）来确定疾病严重程度。
在MRI1和MRI2时，所有MRA的主观图像质量均具有诊断价值（平均评分=4.7±0.6）。CNR和SNR分别为443.8±8.7和50.5±8.7。对于COPD和CF患者，图像质量评分、CNR或SNR均与FEV1%或胸部MRI评分无关（r=0.239 - 0.248）。从MRI1到MRI2，CNR和SNR没有变化（P=0.434 - 0.995）。此外，MRI1和MRI2时MRA之间CNR和SNR的微小差异与COPD和CF患者的FEV1%、胸部MRI评分均无关（r=-0.238 - 0.183），与COPD患者的EI也无关（r=0.100 - 0.111）。
MRA在COPD和CF患者中达到了诊断质量，并且无论疾病严重程度如何都具有高度可重复性。这支持MRA作为潜在黏液阻塞性肺病患者CT的可靠替代方法。
