Clinical Potential of UTE-MRI for Assessing COVID-19: Patient- and Lesion-Based Comparative Analysis
Clinical Potential of UTE-MRI for Assessing COVID-19: Patient- and Lesion-Based Comparative Analysis
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DOI：
10.1002/jmri.27208
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发表时间：
2020-06-03
影响因子：
4.4
通讯作者：
Shan, Fei
中科院分区：
文献类型：
--
作者：
Yang, Shuyi;Zhang, Yunfei;Shan, Fei
胸部计算机断层扫描（CT）在COVID-19的筛查、诊断和监测方面显示出巨大的临床潜力。然而，由于在短时间内重复暴露X射线，安全性问题是有必要的。MRI的最新进展表明，超短回波时间MRI（UTE-MRI）在肺部应用中具有价值。目的评价UTE-MRI评估COVID-19的有效性。研究类型前瞻性。人群共23例COVID-19患者，入院和影像学检查之间的平均间隔为2.81天。场强/序列3 T;呼吸门控三维径向UTE脉冲序列。评估图像质量评分。基于患者和病变的观察者间和方法间一致性，用于识别COVID-19的代表性图像结果。统计检验Wilcoxon秩和检验，Kendall一致性系数结果CT和UTE-MRI图像质量无显著性差异，但两者之间存在显著性差异（CT与UTE-MRI：4.3 +/- 0.4与4.0 +/- 0.5，P = 0.09）。此外，CT和UTE-MRI用于评估COVID-19影像学体征的基于患者和病变的观察者间一致性均被确定为极好（ICC：0.939-1.000，P < 0.05; Kendall's W：0.894-1.000，P < 0.05）。此外，用于评估COVID-19代表性结果的两种图像模式的方法间一致性，包括受影响的肺叶、总严重程度评分、磨玻璃样混浊（GGO）、实变、GGO伴实变、疯狂铺路图案的数量、线性混浊以及假空洞，均被确定为实质性或极好（kappa：0.649-1.000，P < 0.05; ICC：0.913-1.000，P < 0.05）.数据结论肺部MRI结合UTE对评估COVID-19的代表性影像学表现具有价值，与CT具有高度一致性。证据等级2技术有效性阶段3
Background Chest computed tomography (CT) has shown tremendous clinical potential for screening, diagnosis, and surveillance of COVID-19. However, safety concerns are warranted due to repeated exposure of X-rays over a short period of time. Recent advances in MRI suggested that ultrashort echo time MRI (UTE-MRI) was valuable for pulmonary applications.Purpose To evaluate the effectiveness of UTE-MRI for assessing COVID-19.Study Type Prospective.Population In all, 23 patients with COVID-19 and with an average interval of 2.81 days between hospital admission and image examination.Field strength/Sequence 3T; Respiratory-gated three-dimensional radial UTE pulse sequence.Assessment Image quality score. Patient- and lesion-based interobserver and intermethod agreement for identifying the representative image findings of COVID-19.Statistical Tests Wilcoxon-rank sum test, Kendall's coefficient of concordance (Kendall's W), intraclass coefficients (ICCs), and weighted kappa statistics.Results There was no significant difference between the image quality of CT and UTE-MRI (CT vs. UTE-MRI: 4.3 +/- 0.4 vs. 4.0 +/- 0.5, P = 0.09). Moreover, both patient- and lesion-based interobserver agreement of CT and UTE-MRI for evaluating the image signs of COVID-19 were determined as excellent (ICC: 0.939-1.000, P < 0.05; Kendall's W: 0.894-1.000, P < 0.05.). In addition, the intermethod agreement of two image modalities for assessing the representative findings of COVID-19 including affected lobes, total severity score, ground glass opacities (GGO), consolidation, GGO with consolidation, the number of crazy paving pattern, and linear opacities, as well as pseudocavity were all determined as substantial or excellent (kappa: 0.649-1.000, P < 0.05; ICC: 0.913-1.000, P < 0.05).Data Conclusion Pulmonary MRI with UTE is valuable for assessing the representative image findings of COVID-19 with a high concordance to CT.Evidence Level 2Technical Efficacy Stage 3