磁共振IDEAL-IQ技术对急性胰腺炎患者脂肪与铁沉积的诊断效能分析

范慧芳; 陈强; 原小军; 罗琳

doi:10.3969/j.issn.1001-5256.2022.10.022

磁共振IDEAL-IQ技术对急性胰腺炎患者脂肪与铁沉积的诊断效能分析

DOI: 10.3969/j.issn.1001-5256.2022.10.022

范慧芳¹,
陈强²,
原小军²,
罗琳^2, , ,

1.
内蒙古科技大学包头医学院，内蒙古包头 014040
2.
内蒙古科技大学包头医学院第一附属医院医学影像科，内蒙古包头 014010

基金项目:

包头医学院科学研究基金项目 (BYJJ-QM201753)

伦理学声明：本研究方案于2022年1月7日经由包头医学院第一附属医院伦理委员会审批，批号：20210012。所有受检者均自愿参加本研究并签署知情同意书。

利益冲突声明：本研究不存在研究者、伦理委员会成员、受试者监护人以及与公开研究成果有关的利益冲突。

作者贡献声明：范慧芳负责文献检索，撰写文章；罗琳对研究的思路或设计有关键贡献，并参与了研究数据的获取分析解释过程；陈强、原小军负责文章的整体指导，审核以及修改完善。

详细信息

通信作者:
罗琳，byll117@sina.com

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出版历程
- 收稿日期: 2022-02-07
- 录用日期: 2022-03-19
- 出版日期: 2022-10-20

Efficacy of magnetic resonance IDEAL-IQ technique in diagnosis of fat and iron deposition in acute pancreatitis

1.
Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia Autonomous Region 014040, China
2.
Department of Medical Radiology, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia Autonomous Region 014010, China

Research funding:

Scientific Research Foundation Project of Baotou Medical College (BYJJ-QM201753)

More Information

Corresponding author: LUO Lin, byll117@sina.com(ORCID: 0000-0002-3661-0252)

摘要

摘要: 目的利用IDEAL-IQ技术定量参数脂肪分量(FF)和弛豫率(R₂^*)对急性胰腺炎(AP)患者胰腺内脂肪沉积和铁沉积进行量化评估，评价其诊断AP的效能。方法纳入2020年10月—2021年10月于内蒙古科技大学包头医学院第一附属医院诊治的AP患者72例为AP组，以同期82例健康体检者为对照组。两组研究对象应用GE 3.0T MRI行腹部IDEAL-IQ序列检查，并在MR后处理工作站测量胰腺FF及R₂^*值。符合正态性分布的计量资料两组间比较采用t检验；不符合正态分布的计量资料两组间比较采用非参数Mann-Whitney U检验。差异有统计学意义的参数进行受试者工作特征曲线分析。以曲线下面积作为评价参数诊断效能的指标。结果病例组中FF值显著高于对照组(Z=-10.01，P＜0.001)，AP组中R₂^*值高于对照组，差异有统计学意义(Z=-3.73，P＜0.001)；而轻度与中重度AP间FF和R₂^*值的差异均无统计学意义(P值均＞0.05)；FF值和R₂^*值诊断AP的敏感度分别为100%、48.6%，特异度分别为90.2%、86.6%。结论磁共振IDEAL-IQ技术定量参数FF值诊断AP的灵敏度和特异度均较高，是诊断AP的特异性指标，具有很好的临床应用前景。
- 胰腺炎 /
- IDEAL-IQ /
- 脂肪沉积 /
- 铁沉积
Abstract: Objective To perform quantitative evaluation of fat and iron deposition in the pancreas of patients with acute pancreatitis (AP) based on the IDEAL-IQ quantitative parameters fat fraction (FF) and relaxation rate (R₂^*), and to investigate the efficacy of this technique in the diagnosis of AP. Methods A total of 72 patients with AP who were diagnosed and treated in The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology from October 2020 to October 2021, were enrolled as case group, and 82 healthy controls who underwent physical examination during the same period of time were enrolled as control group. The abdominal IDEAL-IQ sequence test was performed for both groups using GE 3.0T magnetic resonance instrument, and FF and R₂^* values were measured on post-processing workstation. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. A receiver operating characteristic (ROC) curve analysis was performed for the parameters with statistical significance, and area under the ROC curve (AUC) was used to evaluate the diagnostic efficacy of parameters. Results Compared with the control group, the case group had significantly higher FF value (Z=-10.01, P < 0.001) and R₂^* value (Z=-3.73, P < 0.001), while there were no significant differences in FF and R₂^* values between mild AP and moderate-to-severe AP (P > 0.05). FF value had a sensitivity of 100% and a specificity of 90.2% in the diagnosis of AP, while R₂^* value had a sensitivity of 48.6% and a specificity of 86.6% in the diagnosis of AP. Conclusion The quantitative parameter FF value of magnetic resonance IDEAL-IQ technique has relatively high sensitivity and specificity in the diagnosis of AP, and it is a specific index for the diagnosis of AP and holds promise for clinical application.
- Pancreatitis /
- IDEAL-IQ /
- Fat Deposition /
- Iron Deposition

HTML全文

图 1 AP患者IDEAL-IQ序列重建图像及ROI勾画图示

注：a，水像显示肿胀胰腺的轮廓(白色虚线)；b，FF图；c，R₂^*图。分别于FF图和R₂^*图在胰头(1)、胰体(2)、胰尾(3)勾画ROI(箭头)。

Figure 1. IDEAL-IQ sequence reconstruction image and ROI sketching diagram

下载: 全尺寸图片幻灯片

图 2 胰腺FF和R₂^*值诊断AP效能的ROC曲线

Figure 2. ROC curve of pancreatic FF and R₂^* values for diagnosis of AP

下载: 全尺寸图片幻灯片

表 1 MRSI评分标准

Table 1. MRSI scoring system

MRI表现	评分
胰腺炎症评分
未见明显异常	0
局灶性或弥漫性胰腺增大	1
腺体内信号异常伴胰周脂肪炎性改变	2
单处的、无明确边界的积液或蜂窝组织炎块	3
2处或2处以上无明确边界的积液或积气	4
胰腺坏死评分¹⁾
无坏死	0
＜30%	2
30%~50%	4
＞50%	6
注：MRSI＝胰腺炎症评分+坏死评分；1)胰腺坏死的判断标准，T₁WI呈低信号，T₂WI呈低信号或高信号，增强扫描动脉期、静脉期图像均未见明显强化。

下载: 导出CSV

表 2 腹部MRI平扫及增强扫描主要参数

Table 2. Main parameters of abdominal MRI plain scan and enhanced scan

项目	扫描序列	TR(ms)	TE(ms)	FOV(cm)	层厚(mm)	翻转角
MRI平扫
T₁WI轴位	快速干扰相梯度回波序列	4.2	1.1/2.2	40×32	5	15°
T₂WI轴位	单次激发快速自旋回波序列	7500	76.1	40×40	7	110°
T₂WI抑脂	快速恢复自旋回波饱和脂肪抑制序列	9000	76.1	40×40	7	110°
T₂WI冠位	单次激发快速自旋回波序列	2211	76.1	42×42	6	90°
MRI增强	肝脏快速容积成像序列	3.5	1.3	40×32	5	15°
注：TR，重复时间；TE，回波时间；FOV，视野。所有受试者在屏气状态下行IDEAL-IQ序列扫描，扫描参数为TR 6.6 ms，TE 0.9~4.8 ms，激励次数0.50，FOV 44 cm×44 cm，层厚8 mm，相位数160，翻转角3°，扫描时间18 s。

下载: 导出CSV

表 3 病例组与对照组FF及R₂^*值的比较

Table 3. Comparison of FF and R₂^* between the case and control group

参数	AP组(n=72)	对照组(n=82)	Z值	P值
FF(%)	9.23(7.51~12.33)	3.02(2.00~3.85)	-10.01	＜0.001
R₂^*(Hz)	37.05(25.33~53.56)	28.18(23.85~35.53)	-3.73	＜0.001

下载: 导出CSV

表 4 轻度与中重度AP患者胰腺FF及R₂^*值的比较

Table 4. Comparison of pancreatic FF and R₂^* values between mild group and moderately severe to severe group of AP patients

参数	轻度(n=50)	中重度(n=22)	Z值	P值
FF(%)	9.80(7.44~12.75)	8.30(7.88~10.32)	-1.032	0.299
R₂^*(Hz)	39.27(27.44~53.62)	33.22(23.96~54.97)	-0.274	0.741

下载: 导出CSV

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