零回波时间3.0T MRI用于检出肺癌结节

目的 观察零回波时间(ZTE)3.0T MRI检出肺癌结节的价值。方法 前瞻性纳入126例肺癌患者(共176个肺结节),以3.0T MR仪行肺部轴位ZTE成像和常规序列成像,包括T1容积内插屏气检查(VIBE)、T2刀锋序列(BLADE)及T2半傅里叶采集单次激发快速自旋回波(HASTE)序列扫描;分析ZTE MRI与CT显示肺结节特征的一致性,观察以不同MR序列检出肺结节的敏感度。结果 176个肺结节中,ZTE MRI检出140个、漏诊36个。ZTE MRI与CT显示肺结节最大径及其实性部分最大径的一致性均好(ICC=0.954、0.943,P均<0.001)且差异较小,显示气管血管束、胸膜凹陷及内部支气管充气征的一致性均好(Kappa=0.894、0.912、0.917),显示结节类型及形状的一致性中等(Kappa=0.661、0.501)。ZTE MRI检出肺结节的敏感度均高于其他单独MR序列(P均<0.05);ZTE与T2-BLADE组合的敏感度均高于其他序列组合(P均<0.05)。结论 ZTE 3.0T MRI检出肺癌结节的效能较好,优于常规MR序列;与T2-BLADE联合可进一步提高其敏感度。

Zero echo time 3.0T MRI for detecting lung cancer nodules

Objective To observe the value of zero echo time (ZTE) 3.0T MRI for detecting lung cancer nodules. Methods Totally 126 lung cancer patients (176 lung nodules) were prospectively enrolled and underwent 3.0T MR axial lung scanning, including T1-volumetric interpolated breath-hold examination (VIBE), T2-BLADE, T2-half-Fourier acquisition single-shot turbo spin-echo (HASTE) and ZTE sequences. The consistency between ZTE MRI and previous CT for displaying characteristics of pulmonary nodules was analyzed, and the sensitivity of different MR sequences for detecting pulmonary nodules were observed. Results Among 176 pulmonary nodules showed on CT, ZTE MRI detected 140 and missed 36 ones. The consistency between ZTE MRI and CT for displaying the maximum diameter and actual maximum diameter of pulmonary nodules were both good (ICC=0.954, 0.943, both P<0.001), and the difference between ZTE MRI and CT was small. The consistency between ZTE MRI and CT for displaying tracheal vascular bundles, pleural indentation and internal bronchial inflation signs were all good (Kappa=0.894, 0.912, 0.917), while for displaying the type and shape of nodules were both moderate (Kappa=0.661, 0.501). The sensitivity of ZTE MRI for detecting pulmonary nodules was higher than that of other individual MR sequences (all P<0.05), of combination of ZTE and T2 BLADE was higher than that of other sequence combinations (all P<0.05). Conclusion ZTE 3.0T MRI could be used to detect lung cancer nodules, which was superior to conventional MRI. Combination of ZTE 3.0T MRI with T2-BLADE could improve the sensitivity for detecting pulmonary nodules.