IRM pulmonaire 3D à temps d'écho ultracourt par acquisition spiralée ou sphérique de l'espace-k : évaluation chez des volontaires sains et dans les atteintes parenchymateuses pulmonaires

Abstract : Background: ultrashort echo time (UTE) has been shown to improve lung MR imaging quality in three dimensions. The evaluation of 3D-UTE stack-of-spirals VIBE (3D-USV) sequence for parenchymal diseases and a comparison of performance with that of a spherical mode of acquisition is needed. Purpose: to assess MR imaging quality using a prototypical 3D-USV sequence and to compare performance with that of a spherical acquisition using Pointwise Encoding Time Reduction with Radial Acquisition (PETRA). Study type: monocenter, prospective. Population: twelve healthy volunteers and thirty two adult patients with either cystic fibrosis (CF; n=16) or interstitial lung disease (ILD; n=16). Field strength/sequence: both free-breathing 3D-USV and PETRA were completed at 1.5T. Assessment: in healthy volunteers, visual analysis of imaging quality was scored using a Likert scale. Quantitative evaluation of apparent Signal ratio (Sr) and Contrast ratio (Cr) was measured. Patients with CF and ILD completed both CT and MRI. Depiction of structural alterations was assessed using dedicated clinical scores. All evaluations were done in consensus by two readers. Statistical tests: comparison of means was assessed using Wilcoxon signed rank test. Concordance and agreement between CT and MRI were assessed using intraclass correlation coefficient (ICC) and kappa test. Results: in controls, 3D-USV yielded lower artifacts owing to better automatic respiratory synchronization than PETRA (p<0.001). However, Sr and Cr of 3D-USV were found significantly lower by 2.25 and 2.36-fold, respectively (p<0.001). In patients, 3D-USV and PETRA showed comparable performances to assess airway severity in CF (Bhalla score, ICC=0.89 and ICC=0.92, respectively) and presence of structural alterations in ILD such as honeycombing (kappa=0.68 and kappa=0.69, respectively). Data conclusion: 3D-USV enables high-resolution morphological imaging of the lung without need of an external device to compensate respirator motions. Automation and robustness of the method may facilitate clinical application for both airway and interstitial lung investigations.
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Master Thesis
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Submitted on : Wednesday, April 17, 2019 - 3:33:32 PM
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Joseph Yazbek. IRM pulmonaire 3D à temps d'écho ultracourt par acquisition spiralée ou sphérique de l'espace-k : évaluation chez des volontaires sains et dans les atteintes parenchymateuses pulmonaires. Médecine humaine et pathologie. 2019. ⟨dumas-02102666⟩

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