Yao Feifei, Huang Mengyue, Li Juan, Gao Xuemei
Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Abdom Radiol (NY). 2023 Jun;48(6):2131-2138. doi: 10.1007/s00261-023-03899-w. Epub 2023 Apr 8.
The current study aimed to explore the feasibility of readout-segmented echo-planar imaging (RS-EPI) of the testis at 3.0 T, by comparing with single-shot echo-planar imaging (SS-EPI) in qualitative image quality and quantitative apparent diffusion coefficient (ADC) values.
66 patients undergoing scrotal MRI for various clinical indications were included retrospectively. RS-EPI image quality was rated from 1 (severe distortion or artifact, or nondiagnostic) to 4 (nearly no distortion or artifact, or outstanding). The comparative image quality (RS- vs. SS-EPI) was rated from - 2 (SS-EPI severe or greater conspicuity) to 2 (RS-EPI severe or greater conspicuity). The confidence interval of proportions (CIOP) of comparative image quality and Wilcoxon rank sum test were performed to assess the preferences between RS-EPI and SS-EPI. Paired samples t-test and Bland-Altman analysis were performed to compare the mean ADC values of RS-EPI and SS-EPI. The mean, maximum, and minimum ADC values measured by RS-EPI were compared in normal testicular parenchyma, benign and malignant intratesticular lesions.
The evaluation of RS-EPI image quality showed RS-EPI with the characteristics of slight geometric distortion and susceptibility artifact, and good lesion conspicuity. The assessment of comparative image quality showed SS-EPI with obvious geometric distortion and susceptibility artifact, and RS-EPI preferred in lesion conspicuity. The CIOP ranged from 97 to 100% among three readers, with preferring to RS-EPI improving image quality (P < 0.001). There was a strong correlation and good agreement between mean ADC values measured by RS-EPI and SS-EPI. The mean, maximum and minimum ADC values by RS-EPI were significantly different in normal testicular parenchyma, benign and malignant intratesticular lesions.
RS-EPI DWI of the testis improved image quality in geometric distortion, susceptibility artifacts, and lesion conspicuity, and provided highly correlated and consistent mean ADC values when compared to SS-EPI DWI, indicating the feasibility of RS-EPI DWI of testes.
本研究旨在通过比较读出分段回波平面成像（RS-EPI）和单次激发回波平面成像（SS-EPI）在定性图像质量和定量表观扩散系数（ADC）值方面的差异，探讨3.0 T场强下睾丸RS-EPI成像的可行性。
回顾性纳入66例因各种临床指征接受阴囊MRI检查的患者。RS-EPI图像质量从1分（严重畸变或伪影，或无法诊断）到4分（几乎无畸变或伪影，或非常出色）进行评分。比较图像质量（RS-EPI与SS-EPI）从-2分（SS-EPI严重或更明显）到2分（RS-EPI严重或更明显）进行评分。采用比较图像质量的比例置信区间（CIOP）和Wilcoxon秩和检验来评估RS-EPI和SS-EPI之间的偏好。进行配对样本t检验和Bland-Altman分析以比较RS-EPI和SS-EPI的平均ADC值。比较正常睾丸实质、睾丸内良性和恶性病变中RS-EPI测量的平均、最大和最小ADC值。
RS-EPI图像质量评估显示其具有轻微几何畸变和磁化率伪影的特征，且病变显示良好。比较图像质量评估显示SS-EPI存在明显几何畸变和磁化率伪影，在病变显示方面RS-EPI更具优势。三位阅片者的CIOP范围为97%至100%，倾向于RS-EPI可提高图像质量（P < 0.001）。RS-EPI和SS-EPI测量的平均ADC值之间存在强相关性和良好一致性。RS-EPI在正常睾丸实质、睾丸内良性和恶性病变中的平均、最大和最小ADC值存在显著差异。
睾丸RS-EPI扩散加权成像（DWI）在几何畸变、磁化率伪影和病变显示方面改善了图像质量，与SS-EPI DWI相比，提供了高度相关且一致的平均ADC值，表明睾丸RS-EPI DWI具有可行性。
