UT Southwestern, Dallas, TX, USA.
Radiology & Orthopedic Surgery, UT Southwestern, Dallas, TX, 75390-9178, USA.
Eur Radiol. 2024 May;34(5):3483-3492. doi: 10.1007/s00330-023-10315-w. Epub 2023 Oct 18.
The study aimed to compare ZOOMit diffusion-weighted imaging (DWI) MRI with conventional DWI MRI for visualizing small bones in the foot, soft tissue abscesses, and osteomyelitis.
The cohort consisted of a consecutive series of patients with potential foot and ankle infections referred for MR imaging. Patients were imaged using both conventional and ZOOMit DWI in the same setting. Blinded reads were then conducted in separate settings and independent of known clinical diagnosis by two expert radiologists. The results from the reads were compared statistically using paired t-tests and with biopsy specimen analysis, both anatomopathological and microbiological.
There was improvement in fat suppression using ZOOMit sequence compared to conventional DWI (p = .001) with no significant difference in motion artifacts (p = .278). ZOOMit had a higher rate of concordance with pathology findings for osteomyelitis (72%, 31/43 cases) compared with conventional DWI (60%, 26/43 cases). ZOOMit also identified 46 additional small bones of the foot and ankle (405/596, 68.0%) than conventional DWI (359/596, 60.2%). Conventional DWI however exhibited a more negative contrast-to-noise ratio (CNR) than ZOOMit (p = 0.001).
ZOOMit DWI improves distal extremity proton diffusion assessment and helps visualize more bones in the foot, with less image distortion and improved fat saturation at the expense of reduced CNR. This makes it a viable option for assessing lower extremity infections.
This study highlights the novel utilization of ZOOMit diffusion-weighted imaging (DWI) for the assessment of lower extremity lesions compared to conventional DWI.
• Distal extremity diffusion-weighted imaging (DWI) is often limited. • ZOOMit DWI displayed improved fat suppression with less motion artifacts and better visualization of the lower extremity bones than conventional DWI. • ZOOMit shows decreased contrast-to-noise ratio than conventional DWI.
本研究旨在比较 ZOOMit 扩散加权成像（DWI）MRI 与常规 DWI MRI 在显示足部小骨、软组织脓肿和骨髓炎方面的效果。
本队列由一系列疑似足部和踝关节感染的连续患者组成，这些患者均在同一部位接受了常规和 ZOOMit DWI 成像。然后，由两位专家放射科医生在不同的环境中进行独立的盲法读片，且不了解已知的临床诊断。使用配对 t 检验和活检标本分析（包括解剖病理学和微生物学分析）对读片结果进行统计学比较。
与常规 DWI 相比，ZOOMit 序列的脂肪抑制效果得到了改善（p =.001），而运动伪影没有明显差异（p =.278）。ZOOMit 对骨髓炎的病理发现与常规 DWI 相比具有更高的一致性（72%，43/60 例）。ZOOMit 还比常规 DWI 多发现了 46 个足部和踝关节的小骨（405/596，68.0%）（359/596，60.2%）。然而，常规 DWI 的对比噪声比（CNR）比 ZOOMit 更负（p = 0.001）。
ZOOMit DWI 改善了远端肢体质子扩散评估，并有助于更多地显示足部骨骼，同时减少图像失真和改善脂肪饱和度，但代价是降低 CNR。这使其成为评估下肢感染的一种可行选择。
本研究强调了 ZOOMit 扩散加权成像（DWI）在评估下肢病变方面的新应用，与常规 DWI 相比。
• 远端肢体扩散加权成像（DWI）常受限制。• ZOOMit DWI 显示出比常规 DWI 更好的脂肪抑制效果、更少的运动伪影，并且能够更好地显示下肢骨骼。• ZOOMit 显示的对比噪声比低于常规 DWI。
