Wada Danilo Tadao, Wada Li Siyuan, Machado Camila Vilas Boas, Lourenço Mateus Repolês, de Nadai Tales Rubens, Cipriano Federico Enrique Garcia, Fabro Alexandre Todorovic, Koenigkam-Santos Marcel
Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
Faculdade de Medicina de Bauru da Universidade de São Paulo (FMBRU-USP), Bauru, SP, Brazil.
Radiol Bras. 2024 Sep 30;57:e20240033. doi: 10.1590/0100-3984.2024.0033. eCollection 2024 Jan-Dec.
To explore the feasibility of two magnetic resonance imaging (MRI) sequences-high-resolution T2-weighted (HR T2) and Look-Locker T1 (LL T1) relaxometry-for the investigation focal lung lesions (FLLs). As a secondary objective, we analyzed the diagnostic accuracy of these sequences.
This was a prospective observational study involving 39 subjects with FLLs scanned in a 1.5-T MRI system with LL T1 relaxometry and HR T2 sequences focused on the FLL region, in addition to a conventional protocol. All images were evaluated by two radiologists, working independently, who were blinded to other findings.
Most of the examinations (31 of the LL T1 relaxometry sequences and 36 of the HR T2 sequences) were of adequate diagnostic quality. Nondiagnostic examinations were considered so mainly because of limited coverage of the sequences. Of the FLLs studied, 19 were malignant, 17 were benign, and three were excluded from the accuracy analysis because there was no definitive diagnosis. Although LL T1 relaxometry could not distinguish between benign and malignant lesions, the signal intensity at its first inversion time (160 ms) differed between the two groups. The HR T2 sequence was considered the best sequence for assessing specific morphological characteristics, especially pseudocavities and pleural tags. We found that MRI showed better accuracy than did computed tomography (86% vs. 74%).
Both MRI sequences are feasible for the evaluation of FLLs. Images at 160 ms of the LL T1 relaxometry sequence helped distinguish between benign and malignant lesions, and the HR T2 sequence was considered the best sequence for evaluating specific morphological characteristics.
探讨两种磁共振成像（MRI）序列——高分辨率T2加权（HR T2）和Look-Locker T1（LL T1）弛豫测量法——用于研究局灶性肺病变（FLLs）的可行性。作为次要目的，我们分析了这些序列的诊断准确性。
这是一项前瞻性观察性研究，纳入了39例患有FLLs的受试者，除了常规方案外，还在1.5-T MRI系统中采用LL T1弛豫测量法和聚焦于FLL区域的HR T2序列进行扫描。所有图像均由两名独立工作的放射科医生进行评估，他们对其他检查结果不知情。
大多数检查（LL T1弛豫测量法序列中的31例和HR T2序列中的36例）具有足够的诊断质量。非诊断性检查主要是因为序列覆盖范围有限。在所研究的FLLs中，19例为恶性，17例为良性，3例因无明确诊断而被排除在准确性分析之外。虽然LL T1弛豫测量法无法区分良性和恶性病变，但两组在其首次反转时间（160毫秒）的信号强度有所不同。HR T2序列被认为是评估特定形态特征的最佳序列，尤其是假空洞和胸膜征。我们发现MRI的准确性优于计算机断层扫描（86%对74%）。
两种MRI序列均可用于评估FLLs。LL T1弛豫测量法序列在160毫秒时的图像有助于区分良性和恶性病变，HR T2序列被认为是评估特定形态特征的最佳序列。
