目的:本研究的目的是比较三种磁共振成像(MRI)读取方法在多发性硬化症(MS)患者随访中的表现。
方法:这项回顾性研究包括在2016年9月至2019年12月期间接受了两次脑部随访MRI检查和三维液体衰减倒置恢复(FLAIR)序列的MS患者。两名神经放射科住院医师使用包括常规阅读(CR)在内的三种后处理方法独立审查了FLAIR图像,共配准融合(CF),以及带有颜色编码(CS)的共配准减法,而对FLAIR图像以外的所有数据都是盲目的。新的存在和数量,成长,或缩小的病变在阅读方法之间进行比较。阅读时间,阅读信心,还评估了观察员之间和内部的协定。一位神经放射专家建立了参考标准。统计分析针对多重测试进行校正。
结果:共纳入198例MS患者。有130名女性和68名男性,平均年龄为41±12(标准差)岁(年龄范围:21-79岁)。使用CS和CF,与CR相比,检测到更多新病变的患者(93/198[47%]和79/198[40%]vs.54/198[27%],分别;P<0.01)。与CR相比,使用CS和CF检测到的新的高强度FLAIR病变的中位数明显更高(2[Q1,Q3:0,6]和1[Q1,Q3:0,3]与0[Q1,Q3:0,1],分别;P<0.001)。与CR相比,CS和CF的平均阅读时间明显缩短(P<0.001),对读数有更高的信心,观察者之间和观察者之间的协议也更高。
结论:后处理工具,如CS和CF,大大提高了MS患者后续MRI检查的准确性,同时减少了阅读时间,增加了读者的信心和可重复性。
OBJECTIVE: The purpose of this study was to compare the performance of three magnetic resonance imaging (MRI) reading methods in the follow-up of patients with multiple sclerosis (MS).
METHODS: This retrospective study included patients with MS who underwent two brain follow-up MRI examinations with three-dimensional fluid-attenuated inversion recovery (FLAIR) sequences between September 2016 and December 2019. Two neuroradiology residents independently reviewed FLAIR images using three post-processing methods including conventional reading (CR), co-registration fusion (CF), and co-registration subtraction with color-coding (CS), while being blinded to all data but FLAIR images. The presence and number of new, growing, or shrinking lesions were compared between reading methods. The reading time, reading confidence, and inter- and intra-observer agreements were also assessed. An expert neuroradiologist established the standard of reference. Statistical analyses were corrected for multiple testing.
RESULTS: A total of 198 patients with MS were included. There were 130 women and 68 men, with a mean age of 41 ± 12 (standard deviation) years (age range: 21-79 years). Using CS and CF, more patients were detected with new lesions compared to CR (93/198 [47%] and 79/198 [40%] vs. 54/198 [27%], respectively; P < 0.01). The median number of new hyperintense FLAIR lesions detected was significantly greater using CS and CF compared to CR (2 [Q1, Q3: 0, 6] and 1 [Q1, Q3: 0, 3] vs. 0 [Q1, Q3: 0, 1], respectively; P < 0.001). The mean reading time was significantly shorter using CS and CF compared to CR (P < 0.001), with higher confidence in readings and higher inter- and intra-observer agreements.
CONCLUSIONS: Post-processing tools such as CS and CF substantially improve the accuracy of follow-up MRI examinations in patients with MS while reducing reading time and increasing readers\' confidence and reproducibility.