低场 0.55T MRI 用于评估肺磨玻璃和纤维化样混浊：读者间和模态间一致性。
Low-field 0.55 T MRI for assessment of pulmonary groundglass and fibrosis-like opacities: Inter-reader and inter-modality concordance.
机构信息
Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA.
Division of Pulmonary, Sleep and Critical Care Medicine, Department of Medicine, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA.
出版信息
Eur J Radiol. 2022 Nov;156:110515. doi: 10.1016/j.ejrad.2022.110515. Epub 2022 Sep 8.
PURPOSE
To evaluate detection and characterization of groundglass and fibrosis-like opacities imaged by non-contrast 0.55 Tesla MRI, and versus clinically-acquired chest CT images, in a cohort of post-Covid patients.
MATERIALS AND METHODS
64 individuals (26 women, mean age 53 ± 14 years, range 19-85) with history of Covid-19 pneumonia were recruited through a survivorship registry, with 106 non-contrast low-field 0.55 T cardiopulmonary MRI exams acquired from 9/8/2020-9/28/2021. MRI exams were obtained at an average interval of 9.5 ± 4.5 months from initial symptom report (range 1-18 months). Of these, 20 participants with 22 MRI exams had corresponding clinically-acquired CT chest imaging obtained within 30 days of MRI (average interval 18 ± 9 days, range 0-30). MR and CT images were reviewed and scored by two thoracic radiologists, for presence and extent of lung opacity by quadrant, opacity distribution, and presence versus absence of fibrosis-like subpleural reticulation and subpleural lines. Scoring was performed for each of four lung quadrants: right upper and middle lobe, right lower lobe, left upper lobe and lingula, and left lower lobe. Agreement between readers and modalities was assessed with simple and linear weighted Cohen's kappa (k) coefficients.
RESULTS
Inter-reader concordance on CT for opacity presence, opacity extent, opacity distribution, and presence of subpleural lines and reticulation was 99%, 78%, 97%, 99%, and 94% (k 0.96, 0.86, 0.94, 0.97, 0.89), respectively. Inter-reader concordance on MR, among all 106 exams, for opacity presence, opacity extent, opacity distribution, and presence of subpleural lines and reticulation was 85%, 48%, 70%, 86%, and 76% (k 0.57, 0.32, 0.46, 0.47, 0.37), respectively. Inter-modality agreement between CT and MRI for opacity presence, opacity extent, opacity distribution, and presence subpleural lines and reticulation was 86%, 52%, 79%, 93%, and 76% (k 0.43, 0.63, 0.65, 0.80, 0.52).
CONCLUSION
Low-field 0.55 T non-contrast MRI demonstrates fair to moderate inter-reader concordance, and moderate to substantial inter-modality agreement with CT, for detection and characterization of groundglass and fibrosis-like opacities.
目的
评估非对比 0.55 特斯拉 MRI 检测和特征描述新冠肺炎后患者肺部磨玻璃影和纤维化样混浊的能力，并与临床获得的胸部 CT 图像进行对比。
材料与方法
通过幸存者登记册招募了 64 名（26 名女性，平均年龄 53 ± 14 岁，范围 19-85 岁）有新冠肺炎肺炎病史的患者，共进行了 106 次非对比低场 0.55 T 心肺 MRI 检查，这些检查于 2020 年 9 月 8 日至 2021 年 9 月 28 日获得。MRI 检查在初始症状报告后平均间隔 9.5 ± 4.5 个月（范围 1-18 个月）进行。其中，20 名参与者的 22 次 MRI 检查在 MRI 检查后 30 天内获得了相应的临床胸部 CT 图像（平均间隔 18 ± 9 天，范围 0-30 天）。MR 和 CT 图像由两名胸部放射科医生进行回顾和评分，用于评估肺混浊的存在和程度、混浊分布以及纤维化样胸膜下网状结构和胸膜下线的存在。评分针对四个肺象限中的每一个进行：右上和中叶、右下叶、左上叶和舌叶、以及左下叶。使用简单和线性加权 Cohen's kappa (k) 系数评估读者和模态之间的一致性。
结果
读者之间在 CT 上对混浊存在、混浊程度、混浊分布以及胸膜下线和网状结构的存在的一致性分别为 99%、78%、97%、99%和 94%（k 0.96、0.86、0.94、0.97、0.89）。在所有 106 次检查中，读者之间在 MR 上对混浊存在、混浊程度、混浊分布以及胸膜下线和网状结构的存在的一致性分别为 85%、48%、70%、86%和 76%（k 0.57、0.32、0.46、0.47、0.37）。CT 和 MRI 之间在混浊存在、混浊程度、混浊分布以及胸膜下线和网状结构存在方面的一致性分别为 86%、52%、79%、93%和 76%（k 0.43、0.63、0.65、0.80、0.52）。
结论
0.55 T 非对比低场 MRI 对检测和描述新冠肺炎后患者的磨玻璃影和纤维化样混浊具有中等至高的读者间一致性，与 CT 具有中等至高的模态间一致性。
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