肺实质病变的3T-MRI和CT对照研究  

Correlation between computed tomographic and 3T magnetic resonance imaging findings of parenchymal lung diseases

作　　者：严琴琴 沈杰[1] 卢水华 单飞[1] 施裕新[1] Yan Qinqin;Shen Jie;Lu Shuihua;Shan Fei;Shi Yuxin(Department of Radiology,Shanghai Public Health Clinical Center,Fudan University,Shanghai 201508,China;Department of Tuberculosis,Shanghai Public Health Clinical Center,Fudan University,Shanghai 201508,China)

机构地区：[1]上海市(复旦大学附属)公共卫生临床中心影像科,上海201508 [2]上海市(复旦大学附属)公共卫生临床中心结核科,上海201508

出　　处：《新发传染病电子杂志》2021年第1期49-53,共5页Electronic Journal of Emerging Infectious Diseases

摘　　要：目的探讨优选肺MRI序列对肺部基本病变的检测效能。方法收集2018年10月至2020年1月在上海市(复旦大学附属)公共卫生临床中心因肺部疾病行3T-MRI检查的患者178例。随机选取60例患者行4个序列的3T-MRI检查,序列包括星状容积内插屏息检查(Star-VIBE)和容积内插屏息检查(VIBE),快速刀锋自旋回波序列(fBLADE TSE)和三维可变反转角快速自旋回波序列(3D-SPACE),以CT为参照,比较4个序列图像的信噪比、对比度、5分评分,以及4个序列的病灶检出率。结果Star-VIBE信噪比明显高于VIBE,对比度和5分评分差异无统计学意义;fBLADE TSE信噪比和5分评分明显高于3D-SPACE,对比度低于3D-SPACE;Star-VIBE和VIBE,fBLADE TSE和3D-SPACE病灶检出率差异无统计学意义。以CT为参照,<6mm、6~8mm、8~10mm及≥10mm结节的MRI检出率分别为90.5%、95.6%、100%和100%,钙化结节检出率为80.3%,实变、磨玻璃灶、空洞、分叶、毛刺、条索、胸膜反应、树芽征、粟粒样结节、卫星灶的检出率和CT相当,胸膜凹陷征和支气管征象的检出率弱于CT,干酪结节、液化、黏液栓、阻塞性肺炎等的检出率优于CT。结论自由呼吸的T1WI Star-VIBE和T2WI fBLADE TSE可提供较高质量的图像。MRI能有效检出肺内基本病变,干酪结节、液化、黏液栓、阻塞性肺炎等的检出率优于CT。Objective To optimize the pulmonary 3T magnetic resonance sequences and evaluate the diagnostic performance of parenchymal lung diseases.Methods 178 patients underwent chest 3TMRI including star-volumetric interpolated breath-hold(Star-VIBE),VIBE,fast BLADE turbo spin echo(fBLADE TSE)and three-dimension sampling perfection with application optimized contrasts using different flip angle evolution(3D-SPACE).Image quality and detection rate of four sequences from random 60 patients were compared.And CT as reference was used for evaluation of detection.Results SNR of Star-VIBE was statistically higher than VIBE.Comparisons of CNR and 5-point scores had no difference.SNR and 5-point scores of fBLADE TSE was statistically higher than 3D-SPACE.The CNR of fBLADE TSE was lower than 3D-SPACE.Detection rate between Star-VIBE and VIBE,fBLADE TSE and 3D-SPACE had no difference.The sensitivity of nodules<6mm,6-8mm,8-10mm and≥10mm was 90.5%,95.6%,100%and 100%.3T-MRI sensitivity of calcified nodules was 80.3%.3T-MRI was comparable to CT in detecting consolidation,ground-glass opacities,cavity,lobulation,spiculation,stripe,pleural reaction,tree-in-bud sign,miliary nodules,satellite lesions.3T-MRI was inferior to CT in detection of pleural indention and bronchiectasis.3T-MRI was superior to present caseous necrosis,liquefaction,mucus plug and obstructive pneumonia.Conclusions free-breathing Star-VIBE and fBLADE TSE can provide high-quality images.And 3T-MRI is comparable to CT for pulmonary parenchyma lesions and has advantages of identifying caseous necrosis,liquefaction,mucus plug and obstructive pneumonia.

关 键 词：肺部磁共振成像 体层摄影术 X线计算机 图像质量 检出 

分 类 号：R563[医药卫生—呼吸系统] R445.2[医药卫生—内科学] R816.4[医药卫生—临床医学]