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문제 정의
- The purpose of the present study was to compare T1FLAIR and T1SE sequences for the evaluation of enhancing intracranial tumors.
제안 방법
- 5 Tesla MR scanners were used in all patients (Magnetom Avanto/Sonata; Siemens Healthcare, Erlangen, Germany). Imaging studies included contrast-enhanced (CE) axial T1SE images (TR/TE, 414 ms/11 ms; acquisition time, 1 minute 33 seconds; slice thickness/gap, 5 mm/1-1.5 mm) and CE axial T1FLAIR images (TR/TEeff, 2000 ms/8.8 ms; inversion time, 860 ms; acquisition time, 1 minute 54 seconds; slice thickness/gap, 5 mm/1-1.5 mm).
- Region-of-interest (ROI) analysis was performed for CE T1SE and CE T1FLAIR images by a single investigator. For quantitative assessment, we measured signal intensities (SIs) by a ROI analysis of the tumor, WM, cortical GM, and cerebrospinal fluid (CSF), respectively. SI was also measured in the air space for the measurement of image noise.
- The lesion-to-WM CR was defined as the difference between the lesion and WM SIs divided by the WM SI [CRlesion-to-WM = (SIlesion - SIWM) / SIWM] and the lesion-to-WM CNR was defined as the difference between the signals from the lesion and WM divided by the standard deviation (SD) of measured image noise [CNRlesion-to-WM = (SIlesion - SIWM) / SDbackground noise]. Similar calculations were performed for lesion-to-GM CR and CNR, lesion-to-CSF CR and CNR, and WM-to-GM CR and CNR. The paired sample t-test was used for comparison of quantitative data between T1SE sequence and T1 FLAIR sequence.
대상 데이터
- 28 patients had primary tumors and 24 patients had metastatic tumors from the remote sites. The primary tumors consisted of meningiomas (n=14), schwannomas (n=6), glioblastomas (n=5), oligodendroglioma (n=1), hemangioblastoma (n=1), and pineal tumor (n=1), respectively. The primary neoplasms of the metastatic tumors were lung cancer (n=18), breast cancer (n=3), rectal cancer (n=2), and ovarian cancer (n=1), respectively.
- A total of 79 enhancing tumors (31 primaries, 48 metastases) in 52 patients were evaluated. The size of the tumors was 0.
- 1. A 44-year-old man with a meningioma in the anterior cranial fossa.
- 2. A 47-year-old woman with a metastatic tumor from small cell lung cancer.
- 3. A 52-year-old man with multiple metastatic tumors from small cell lung cancer.
데이터처리
- Similar calculations were performed for lesion-to-GM CR and CNR, lesion-to-CSF CR and CNR, and WM-to-GM CR and CNR. The paired sample t-test was used for comparison of quantitative data between T1SE sequence and T1 FLAIR sequence. A P value of less than 0.
성능/효과
- Eight quantitative criteria were calculated: lesion-to-WM contrast ratio (CR) and contrast-to-noise ratio (CNR), lesion-to-GM CR and CNR, lesion-to-CSF CR and CNR, and WM-to-GM CR and CNR. The lesion-to-WM CR was defined as the difference between the lesion and WM SIs divided by the WM SI [CRlesion-to-WM = (SIlesion - SIWM) / SIWM] and the lesion-to-WM CNR was defined as the difference between the signals from the lesion and WM divided by the standard deviation (SD) of measured image noise [CNRlesion-to-WM = (SIlesion - SIWM) / SDbackground noise].
- The T1FLAIR lesion-to-GM CR and CNR, lesion-to-CSF CR and CNR, WM-to-GM CR and CNR values were higher than those of the T1SE images and they showed statistically significant differences (p < 0.001 in all).
- For the qualitative comparison of lesion conspicuity between T1FLAIR and T1SE imaging, the grading scales (mean ± SD) of both radiologists were 2.69 ± 0.55 and 2.69 ± 0.59, respectively, which means T1FLAIR images were superior to T1SE images for the evaluation of lesion conspicuity (Figs. 1-3).
- Second, in cases of multiple metastatic tumors, only the largest three tumors were evaluated and it could work as a selection bias.
- In conclusion, for the evaluation of enhancing intracranial tumors, T1FLAIR sequence was superior or comparable to T1SE sequence.
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