Fujiwara Masahiro, Kashiwagi Nobuo, Matsuo Chisato, Watanabe Hitoshi, Kassai Yoshimori, Nakamoto Atsushi, Tomiyama Noriyuki
Department of Diagnostic Radiology, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, 〒541-8567 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan.
Skeletal Radiol. 2023 Feb;52(2):233-241. doi: 10.1007/s00256-022-04192-5. Epub 2022 Oct 1.
To evaluate the diagnostic equivalency between an ultrafast (1 min 53 s) lumbar MRI protocol using deep learning-based reconstruction and a conventional lumbar MRI protocol (12 min 31 s).
This study included 58 patients who underwent lumbar MRI using both conventional and ultrafast protocols, including sagittal T1-weighted, T2-weighted, short-TI inversion recovery, and axial T2-weighted sequences. Compared with the conventional protocol, the ultrafast protocol shortened the acquisition time to approximately one-sixth. To compensate for the decreased signal-to-noise ratio caused by the acceleration, deep learning-based reconstruction was applied. Three neuroradiologists graded degenerative changes and analyzed for presence of other pathologies. For the grading of degenerative changes, interprotocol intrareader agreement was assessed using kappa statics. Interchangeability between the two protocols was also tested by calculating the individual equivalence index between the intraprotocol interreader agreement and interprotocol interreader agreement. For the detection of other pathologies, interprotocol intrareader agreement was assessed.
For the grading of degenerative changes, the kappa values for interprotocol intrareader agreement of all three readers ranged from 0.707 to 0.804, indicating substantial to almost perfect agreement. Except for foraminal stenosis and disc contour on axial images, the 95% confidence interval of the individual equivalence index was < 5%, indicating the two protocols were interchangeable. For the detection of other pathologies, the interprotocol intrareader agreement rates were > 98% for each individual pathology.
Our proposed ultrafast lumbar spine MRI protocol provided almost equivalent diagnostic results to that of the conventional protocol, except for some degenerative changes.
评估基于深度学习重建的超快(1分53秒)腰椎MRI方案与传统腰椎MRI方案(12分31秒)之间的诊断等效性。
本研究纳入了58例接受传统和超快方案腰椎MRI检查的患者,包括矢状位T1加权、T2加权、短TI反转恢复和轴位T2加权序列。与传统方案相比,超快方案将采集时间缩短至约六分之一。为了补偿加速导致的信噪比降低,应用了基于深度学习的重建技术。三名神经放射科医生对退变改变进行分级,并分析是否存在其他病变。对于退变改变的分级,使用kappa统计量评估协议内阅片者间的一致性。还通过计算协议内阅片者间一致性与协议间阅片者间一致性之间的个体等效指数,测试了两种方案之间的互换性。对于其他病变的检测,评估了协议内阅片者间的一致性。
对于退变改变的分级,所有三名阅片者的协议内阅片者间一致性kappa值范围为0.707至0.804,表明一致性为实质性至几乎完美。除了椎间孔狭窄和轴位图像上的椎间盘轮廓外,个体等效指数的95%置信区间<5%,表明两种方案可互换。对于其他病变的检测,每种个体病变的协议内阅片者间一致率>98%。
我们提出的超快腰椎MRI方案除了一些退变改变外,提供了与传统方案几乎等效的诊断结果。