Detecting small pulmonary nodules with spiral ultrashort echo time sequences in 1.5 T MRI
Detecting small pulmonary nodules with spiral ultrashort echo time sequences in 1.5 T MRI
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DOI：
10.1007/s10334-020-00885-x
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发表时间：
2020-09-09
影响因子：
2.3
通讯作者：
Chang, Yeun-Chung
中科院分区：
文献类型：
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作者：
Huang, Yu-Sen;Niisato, Emi;Chang, Yeun-Chung
目的探讨1.5 T磁共振成像（MRI）超短回波时间（UTE）序列对肺小结节的检测价值。材料与方法回顾性分析120例165个胸腔镜下肺小结节患者。MRI序列包括常规容积内插式屏气检查（VIBE，扫描时间16 s）、自由呼吸螺旋UTE (TE 0.05 ms)（扫描时间3.5-5 min）和屏气序列（扫描时间20 s）。胸部CT为结节大小和形态提供了标准参考。结节检测灵敏度按叶对叶进行评估。结果螺旋UTE自由呼吸序列的结节检出率（> 78%,p < 0.05）和憋气序列的结节检出率（> 75%,p < 0.05）明显高于常规VIBE(> 55%)，当结节大小为> 16 mm时结节检出率为100%，当结节形态为固体形态时，无论结节大小如何，结节检出率均为95%。自由呼吸与憋气螺旋UTE序列间信度较好（kappa > 0.80）。螺旋UTE序列的读者间一致性也很高（kappa > 0.77）。CT和螺旋UTE MRI之间的结节大小测量一致，最小偏差达0.2 mm。螺旋UTE序列检测需要手术的小肺结节，为临床工作提供真实的扫描时间，并且可以作为常规肺部MRI的一部分实施。
Objective This study investigated ultrashort echo time (UTE) sequences in 1.5 T magnetic resonance imaging (MRI) for small lung nodule detection. Materials and methods A total of 120 patients with 165 small lung nodules before video-associated thoracoscopic resection were enrolled. MRI sequences included conventional volumetric interpolated breath-hold examination (VIBE, scan time 16 s), spiral UTE (TE 0.05 ms) with free-breathing (scan time 3.5-5 min), and breath-hold sequences (scan time 20 s). Chest CT provided a standard reference for nodule size and morphology. Nodule detection sensitivity was evaluated on a lobe-by-lobe basis. Results The nodule detection rate was significantly higher in spiral UTE free-breathing (> 78%,p < 0.05) and breath-hold sequences (> 75%,p < 0.05) compared with conventional VIBE (> 55%), reaching 100% when nodule size was > 16 mm, and reaching 95% when nodules were in solid morphology, regardless of size. The inter-sequence reliability between free-breathing and breath-hold spiral UTE was good (kappa > 0.80). Inter-reader agreement was also high (kappa > 0.77) for spiral UTE sequences. Nodule size measurements were consistent between CT and spiral UTE MRI, with a minimal bias up to 0.2 mm. Discussion Spiral UTE sequences detect small lung nodules that warrant surgery, offers realistic scan times for clinical work, and could be implemented as part of routine lung MRI.