Quantitative susceptibility mapping improves cerebral microbleed detection relative to susceptibility-weighted images.
Quantitative susceptibility mapping improves cerebral microbleed detection relative to susceptibility-weighted images.
复制标题
相对于磁敏度加权图像，定量磁敏图可改善脑微出血检测。
DOI：
10.1111/jon.13054
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Soman,Salil
中科院分区：
文献类型：
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作者：
Lee,Kyuwon;Ellison,Brian;Selim,Magdy;Long,NgoH;Filippidis,Aristotelis;Thomas,AjithJ;Spincemaille,Pascal;Wang,Yi;Soman,Salil
背景和目的脑微出血(CMB)的检测影响疾病的诊断和治疗。CMBS的磁化率加权成像(SWI)MRI图像与相位图像(SWIP)一起使用，通过定性的强度评估(亮/暗)来区分血液和钙化。然而，在连续的SWIP图像平面内和跨连续的SWIP图像平面上，单个病变的信号强度可能不同，这影响了将发现归类为CMB。我们假设定量磁化率图(QSM)MRI显示了较小的平面内和通过平面内的强度变化，提高了临床医生将发现归类为CMB的能力。方法48例急性颅内出血患者接受了多回波梯度回波磁共振成像，用来生成SWI/SWIP和形态启用的偶极反转QSM图像。一名神经放射科医生和两名放射科住院医师根据已公布的分级标准，将560个病灶目测分类为均质或异质的平面内和平面内信号。当可能时，分析脑部CT扫描是否有钙化或急性出血。结果QSM显示明确病变信号强度的频率是SWIP的3倍(RR=0.3235，95%CI 0.2386~0.4386，p<；0.0001)。小(RR=0.3172，95%CI 0.2382~0.4225，p&t；0.0001)、大(RR=0.3431，95%CI 0.2045~0.5758，p<；0.0001)、脑叶(RR=0.3215，95%CI 0.2151~0.4805，p&t；0.0001)、小脑(RR=0.3215，95%CI 0.2151~0.4805，p<；脑干(RR=0.3100，95%CI 0.1192-0.8061，p=.0163)和基底节(RR=0.3380，95%CI 0.1980-0.5769，p<；0.0001)损害。结论与SWIP相比，QSM在区分CMBS和钙化方面更具一致性。
Background and PurposeCerebral microbleed (CMB) detection impacts disease diagnosis and management. Susceptibility‐weighted imaging (SWI) MRI depictions of CMBs are used with phase images (SWIP) to distinguish blood from calcification, via qualitative intensity evaluation (bright/dark). However, the intensities depicted for a single lesion can vary within and across consecutive SWIP image planes, impairing the classification of findings as a CMB. We hypothesize that quantitative susceptibility mapping (QSM) MRI, which maps tissue susceptibility, demonstrates less in‐ and through‐plane intensity variation, improving the clinician's ability to categorize a finding as a CMB.MethodsForty‐eight patients with acute intracranial hemorrhage who received multi‐echo gradient echo MRI used to generate both SWI/SWIP and morphology‐enabled dipole inversion QSM images were enrolled. Five hundred and sixty lesions were visually classified as having homogeneous or heterogeneous in‐plane and through‐plane intensity by a neuroradiologist and two diagnostic radiology residents using published rating criteria. When available, brain CT scans were analyzed for calcification or acute hemorrhage. Relative risk (RR) ratios and confidence intervals (CIs) were calculated using a generalized linear model with log link and binary error.ResultsQSM showed unambiguous lesion signal intensity three times more frequently than SWIP (RR = 0.3235, 95% CI 0.2386‐0.4386,p<.0001). The probability of QSM depicting homogeneous lesion intensity was three times greater than SWIP for small (RR = 0.3172, 95% CI 0.2382‐0.4225,p<.0001), large (RR = 0.3431, 95% CI 0.2045‐0.5758,p<.0001), lobar (RR = 0.3215, 95% CI 0.2151‐0.4805,p<.0001), cerebellar (RR = 0.3215, 95% CI 0.2151‐0.4805,p<.0001), brainstem (RR = 0.3100, 95% CI 0.1192‐0.8061,p= .0163), and basal ganglia (RR = 0.3380, 95% CI 0.1980‐0.5769,p<.0001) lesions.ConclusionsQSM more consistently demonstrates interpretable lesion intensity compared to SWIP as used for distinguishing CMBs from calcification.