磁共振T1和T2 mapping评估纵隔肿块：可行性研究。T1 and T2 Mapping for Characterization of Mediastinal Masses: A Feasibility study
目的：评价T1和T2 mapping在纵隔肿块定性诊断中的可行性和实用性。方法：从2019年8月到2021年12月，47名患者接受了3.0T胸部MRI检查，使用改良的look-locker反转恢复序列进行T1和增强后T1 mapping，并使用T2预备单次稳态自由进动技术进行T2mapping。通过绘制纵隔肿块中的感兴趣区域来测量平均native T1（初始T1值）、native T2（初始T2值）和增强后T1值，并使用这些值计算增强指数（EI）。结果：所有mapping图像均获得成功，无明显伪影。其中胸腺上皮肿瘤（TET）25例，神经鞘瘤3例，淋巴瘤6例，胸腺囊肿9例，其他囊性肿瘤4例。TET、神经鞘瘤和淋巴瘤被归为“实体瘤”，与胸腺囊肿和其他肿瘤（“囊性肿瘤”）进行比较。平均增强后T1 mapping（P<.001）、native T2 mapping（P<.001）和EI（P<0.001）值在这两组之间显示出显著差异。在TET中，高危TET（B2、B3型胸腺瘤和胸腺癌）显示出明显高于低风险TET（A、B1和AB型胸腺瘤）的native T2 mapping值（P=0.002）。对于所有测量变量，评分者间的可靠性从好到优（组内系数[ICC]:.869～.990），评分者内的可靠性从优（ICC：.911～.995）。结论：在纵隔肿块的MRI中使用T1和T2 mapping是可行的，可以为纵隔肿块的评估提供更多信息。
关键词：T1 mapping；T2 mapping；磁共振成像；纵隔囊肿；纵隔；胸腺瘤。
Purpose: To evaluate the feasibility and usefulness of T1 and T2 mapping in characterization of mediastinal masses. Methods: From August 2019 through December 2021, 47 patients underwent 3.0-T chest MRI with T1 and post-contrast T1 mapping using modified look-locker inversion recovery sequences and T2 mapping using a T2-prepared single-shot shot steady-state free precession technique. Mean native T1, native T2, and post-contrast T1 values were measured by drawing the region of interest in the mediastinal masses, and enhancement index (EI) was calculated using these values. Results: All mapping images were acquired successfully, without significant artifact. There were 25 thymic epithelial tumors (TETs), 3 schwannomas, 6 lymphomas, and 9 thymic cysts, and 4 other cystic tumors. TET, schwannoma, and lymphoma were grouped together as "solid tumor," to be compared with thymic cysts and other tumors ("cystic tumors"). The mean post-contrast T1 mapping (P < .001), native T2 mapping (P < .001), and EI (P < .001) values showed significant difference between these two groups. Among TETs, high risk TETs (thymoma types B2, B3, and thymic carcinoma) showed significantly higher native T2 mapping values (P = .002) than low risk TETs (thymoma types A, B1, and AB). For all measured variables, interrater reliability was good to excellent (intraclass coefficient [ICC]: .869∼.990) and intrarater reliability was excellent (ICC: .911∼.995). Conclusion: The use of T1 and T2 mapping in MRI of mediastinal masses is feasible and may provide additional information in the evaluation of mediastinal masses.
Keywords: T1 mapping; T2 mapping; magnetic resonance imaging; mediastinal cyst; mediastinum; thymoma.
Beck KS, Chang S, Hyun K, Sung YE, Lee KY, Jung JI. T1 and T2 Mapping for Characterization of Mediastinal Masses: A Feasibility study. Can Assoc Radiol J. 2023 Mar 7:8465371231160052. doi: 10.1177/08465371231160052. Epub ahead of print. PMID: 36882380.
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