融合3D T1/T2 MRI诊断盆腔深浸润性子宫内膜异位症：一项非劣效性研究

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-04-05 DOI:10.1016/j.ejrad.2025.112091

Alexandre Stolz, Lawrence Fabian Pupulim, María Rojas Soldado, Patrick Chabloz, Karen Kinkel

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引用次数: 0

摘要

磁共振成像（MRI）是诊断深浸润性子宫内膜异位症（DIE）必不可少的非侵入性技术。已发表的研究已经探讨了高分辨率脂肪抑制3D t1加权（T1w）和3D t2加权（T2w） MRI在这一主题中的价值。然而，在合并的“PET-scanner-like”多平面重建（fusion 3D T1/T2）中融合这些序列的研究仍然缺乏。我们的主要目的是评估Fusion 3D T1/T2诊断DIE的准确性是否不低于最先进的MRI诊断方案。该标准协议包括在各个平面上的二维T2w图像和在四窗口屏幕上显示的轴向T2w图像（standard）。非劣效性裕度设定为2.5%。59例疑似子宫内膜异位症的骨盆MRI检查由两名不同经验水平的放射科医生（r# 1和r# 2）独立解释，随机采用两种方案。结果与专家小组的一致意见进行了比较。解释时间和读者之间的一致性也进行了评估。采用Fusion 3D T1/T2方案，r# 1对DIE的诊断准确率为94.74% (95%CI: 92.48 ~ 96.47)， r# 2为98.68% (95%CI: 97.31 ~ 99.47)，均不低于STANDARD方案(r# 1, 92.48%, 95%CI: 89.90 ~ 94.57；R#2, 96.43%, 95%ci: 94.48 ~ 97.84)。Fusion 3D T1/T2方案将解释时间缩短了24.5% (P <；0.001)。此外，它提高了阅读器间的可重复性，具有中等水平的一致性(kappa = 0.72；95% CI: 0.63-0.81)，与轻度一致(kappa = 0.47；95% CI: 0.34-0.59)。总之，与目前的MRI标准方案相比，Fusion 3D T1/T2的诊断准确性不差。它还提高了再现性，减少了解释时间，表明其作为诊断盆腔死亡的有价值的工具的潜力。

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Fusion 3D T1/T2 MRI for diagnosing pelvic deep infiltrating endometriosis: a non-inferiority study

Magnetic resonance imaging (MRI) is an essential non-invasive technique for diagnosing deep infiltrating endometriosis (DIE). Published studies have explored the value of high-resolution fat-suppressed 3D T1-weighted (T1w) and 3D T2-weighted (T2w) MRI in this topic. However, research on the fusion of these sequences in a merged ‘PET-scanner-like’ multiplanar reconstruction (Fusion 3D T1/T2) is still lacking.

Our primary objective was to assess whether the diagnostic accuracy of Fusion 3D T1/T2 was non-inferior to the state-of-the-art MRI protocol for diagnosing DIE. This standard protocol consists of 2D T2w images in various planes and axial T1w images displayed on a four-window screen (STANDARD). The non-inferiority margin was set at 2.5 %.

Fifty-nine pelvic MRI examinations for suspected endometriosis were interpreted independently by two radiologists with different experience levels (R#1 and R#2), randomly with both protocols. Results were compared with a consensus opinion from an expert panel. Interpretation time and inter-reader agreement were also evaluated.

Using the Fusion 3D T1/T2 protocol, R#1′s diagnostic accuracy for DIE was 94.74% (95%CI: 92.48–96.47) and R#2′s was 98.68% (95%CI: 97.31–99.47), both of which were non-inferior to the STANDARD protocol (R#1, 92.48%, 95%CI: 89.90–94.57; R#2, 96.43%, 95%CI: 94.48–97.84).

The Fusion 3D T1/T2 protocol reduced interpretation time by 24.5 % (P < 0.001) compared to the STANDARD. Additionally, it improved inter-reader reproducibility, with a moderate level of agreement (kappa = 0.72; 95 % CI: 0.63–0.81), compared to the slight agreement (kappa = 0.47; 95 % CI: 0.34–0.59) observed with the STANDARD protocol.

In conclusion, Fusion 3D T1/T2 demonstrated non-inferior diagnostic accuracy compared to the current MRI standard protocol. It also improved reproducibility and reduced interpretation time, suggesting its potential as a valuable tool for diagnosing pelvic DIE.

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.