可变翻转角与改良Look-Locker反转恢复序列评估肾间质纤维化的对比研究
Comparative Study Between Variable Flip Angle and Modified Look-Locker Inversion Recovery for Evaluating Renal Interstitial Fibrosis.
作者信息
Hua Chenchen, Zhuang Yi, Wang Miaoyan, Cai Ting, Xu Bin, Hao Shaowei, Fang Xiangming, Wang Liang, Zhou Leting
机构信息
Department of Diagnostic Radiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China.
Department of Diagnostic Radiology, Affiliated Children's Hospital of Jiangnan University (Wuxi Children's Hospital), Wuxi, China.
出版信息
J Magn Reson Imaging. 2025 May;61(5):2197-2209. doi: 10.1002/jmri.29611. Epub 2024 Sep 16.
BACKGROUND
Variable flip angle (VFA) and modified Look-Locker inversion recovery (MOLLI) are frequently used for noninvasive evaluation of renal interstitial fibrosis (IF) in chronic kidney disease (CKD). However, controversy remains over which method is preferred.
PURPOSE
To compare the diagnostic efficacy of VFA and MOLLI for T1 mapping in evaluating renal IF.
STUDY TYPE
Prospective.
SUBJECTS
Fifty-one participants with CKD (CKD stage 1-5, 35 males) and 18 healthy volunteers (eight males).
FIELD STRENGTH/SEQUENCE: 3.0 T, three-dimensional gradient echo sequence for B1+ VFA, and two-dimensional gradient echo sequence for MOLLI.
ASSESSMENT
Image quality was assessed on a five-point scale. Cortex and medulla T1 values (cT1 and mT1), corticomedullary T1 value difference (ΔT1, medulla - cortex), and corticomedullary T1 value ratio (ratio T1, cortex:medulla) were compared between VFA and MOLLI as well as between IF grade (0-4) based on biopsy.
STATISTICAL TESTS
Intraclass correlation coefficient, Bland-Altman analysis, analysis of variance, Kruskal-Wallis test, correlation analysis, and receiver operating characteristics analysis with the area under the curve (AUC). P-value <0.05 was considered significant.
RESULTS
MOLLI provided significantly better image quality compared to VFA. cT1 and mT1 values significantly differed between VFA and MOLLI (cT1-VFA: 1771.4 ± 139.4 msec vs. cT1-MOLLI: 1729.9 ± 132.1 msec; mT1-VFA: 2076.0 [interquartile range (IQR): 2045.9-2129.9] msec vs. mT1-MOLLI: 2039.2 [IQR: 1997.8-2071.6] msec). ΔT1 and ratio T1 values were not different between VFA and MOLLI (ΔT1: 300.8 ± 71.4 vs. 306.0 ± 78.4, respectively, P = 0.33 and ratio T1: 0.85 ± 0.038 vs. 0.85 ± 0.041, respectively, P = 0.064). No difference was observed between T1 variables and T1 mapping methods in diagnosing IF.
DATA CONCLUSION
ΔT1 and ratio T1 were not different between VFA and MOLLI. Both VFA and MOLLI are effective for noninvasive assessment of renal IF.
LEVEL OF EVIDENCE
2 TECHNICAL EFFICACY: Stage 2.
背景
可变翻转角（VFA）和改良Look-Locker反转恢复序列（MOLLI）常用于慢性肾脏病（CKD）中肾间质纤维化（IF）的无创评估。然而，对于哪种方法更优仍存在争议。
目的
比较VFA和MOLLI在T1 mapping评估肾IF中的诊断效能。
研究类型
前瞻性研究。
研究对象
51例CKD患者（CKD 1-5期，35例男性）和18名健康志愿者（8名男性）。
场强/序列：3.0 T，用于B1 + VFA的三维梯度回波序列，以及用于MOLLI的二维梯度回波序列。
评估
图像质量采用五分制进行评估。比较VFA和MOLLI之间以及基于活检的IF分级（0-4级）之间的皮质和髓质T1值（cT1和mT1）、皮质髓质T1值差异（ΔT1，髓质-皮质）和皮质髓质T1值比值（比值T1，皮质：髓质）。
统计分析
组内相关系数、Bland-Altman分析、方差分析、Kruskal-Wallis检验、相关性分析以及曲线下面积（AUC）的受试者操作特征分析。P值<0.05被认为具有统计学意义。
结果
与VFA相比，MOLLI提供了显著更好的图像质量。VFA和MOLLI之间的cT1和mT1值存在显著差异（cT1-VFA：1771.4±139.4毫秒 vs. cT1-MOLLI：1729.9±132.1毫秒；mT1-VFA：2076.0[四分位间距（IQR）：2045.9-2129.9]毫秒 vs. mT1-MOLLI：2039.2[IQR：1997.8-2071.6]毫秒）。VFA和MOLLI之间的ΔT1和比值T1值无差异（ΔT1分别为：300.8±71.4 vs. 306.0±78.4，P = 0.33；比值T1分别为：0.85±0.038 vs. 0.85±0.041，P = 0.064）。在诊断IF方面，T1变量和T1 mapping方法之间未观察到差异。
数据结论
VFA和MOLLI之间的ΔT1和比值T1无差异。VFA和MOLLI均可有效用于肾IF的无创评估。
证据水平
2 技术效能：2级
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