Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany.
Department of Internal Medicine II (Hematology and Oncology), University Hospital of Würzburg, Würzburg, Germany.
Acta Radiol. 2023 May;64(5):1851-1858. doi: 10.1177/02841851231151366. Epub 2023 Jan 30.
Ultrashort-echo-time (UTE) sequences have been developed to overcome technical limitations of pulmonary magnetic resonance imaging (MRI). Recently, it has been shown that UTE sequences with breath-hold allow rapid image acquisition with sufficient image quality. However, patients with impaired respiration require alternative acquisition strategies while breathing freely.
To compare the diagnostic performance of free-breathing three-dimensional (3D)-UTE sequences with different trajectories based on pulmonary imaging of immunocompromised patients.
In a prospective study setting, two 3D-UTE sequences performed in free-breathing and exploiting non-Cartesian trajectories-one using a stack-of-spirals and the other exploiting a radial trajectory-were acquired at 3 T in patients undergoing hematopoietic stem cell transplantation. Two radiologists assessed the images regarding presence of pleural effusions and pulmonary infiltrations. Computed tomography (CT) was used as reference.
A total of 28 datasets, each consisting of free-breathing 3D-UTE MRI with the two sequence techniques and a reference CT scan, were acquired in 20 patients. Interrater agreement was substantial for pulmonary infiltrations using both sequence techniques (κ = 0.77 - 0.78). Regarding pleural effusions, agreement was almost perfect in the stack-of-spirals (κ = 0.81) and moderate in the radial sequence (κ = 0.59). No significant differences in detectability of the assessed pulmonary pathologies were observed between both 3D-UTE sequence techniques ( > 0.05), and their level of agreement was substantial throughout (κ = 0.62-0.81). Both techniques provided high sensitivities and specificities (79%-100%) for the detection of pulmonary infiltrations and pleural effusions compared to reference CT.
The diagnostic performance of the assessed 3D-UTE MRI sequences was similar. Both sequences enable the detection of typical inflammatory lung pathologies.
超短回波时间（UTE）序列的开发克服了肺部磁共振成像（MRI）的技术限制。最近，已经表明，屏气的 UTE 序列允许以足够的图像质量快速采集图像。然而，呼吸功能受损的患者需要替代采集策略，同时自由呼吸。
比较基于免疫功能低下患者肺部成像的不同轨迹自由呼吸三维（3D）-UTE 序列的诊断性能。
在一项前瞻性研究中，在 3T 下对接受造血干细胞移植的患者进行了两种自由呼吸的 3D-UTE 序列采集，这两种序列都利用了非笛卡尔轨迹，一种使用堆叠螺旋，另一种利用径向轨迹。两位放射科医生评估了图像中是否存在胸腔积液和肺部浸润。计算机断层扫描（CT）被用作参考。
共采集了 28 个数据集，每个数据集由两种序列技术的自由呼吸 3D-UTE MRI 和参考 CT 扫描组成，共 20 名患者。两种序列技术的肺部浸润的观察者间一致性较高（κ=0.77-0.78）。关于胸腔积液，堆叠螺旋的一致性几乎是完美的（κ=0.81），而径向序列的一致性是中度的（κ=0.59）。两种 3D-UTE 序列技术在评估的肺部病变的检测能力方面没有显著差异（>0.05），并且它们的一致性程度较高（κ=0.62-0.81）。与参考 CT 相比，两种技术在检测肺部浸润和胸腔积液方面均具有较高的灵敏度和特异性（79%-100%）。
评估的 3D-UTE MRI 序列的诊断性能相似。两种序列都可以检测到典型的炎症性肺部病变。
