3D-FIESTA和增强FSPGR序列诊断头颈部肿瘤三叉神经侵犯  

MR Imaging of the Invasion of Trigeminal Nerve in Head and Neck Neoplasms by Using 3D-FIESTA Sequence and Enhanced FSPGR Sequence with Fat-saturation T_1-weighted Imaging

作　　者：程玉书[1,2] 周正荣[1,2] 彭卫军[1,2] 唐峰[1,2] 

机构地区：[1]复旦大学附属肿瘤医院放射科,上海医学院肿瘤学系,上海200032 [2]复旦大学附属眼耳鼻喉科医院放射科,上海200031

出　　处：《放射学实践》2008年第11期1193-1196,共4页Radiologic Practice

基　　金：上海市科委重点基金项目(07JC14014);复旦大学附属肿瘤医院院外合作基金项目(YWHZ200701)

摘　　要：目的:探讨三维快速稳态进支动成像(3D-FIESTA)序列和快速扰相梯度回波(FSPGR)脂肪抑制序列增强扫描在显示头颈部肿瘤三叉神经侵犯中的价值。方法:22例有三叉神经损害症状的患者使用1.5TMR成像仪,进行3D-FIESTA横断面扫描并进行多平面重组,并采用横断面及冠状面FSPGR脂肪抑制序列行增强扫描。重点观察和评价三叉神经脑池段、海绵窦段、圆孔及翼腭窝内上颌支段、卵圆孔及咀嚼肌间隙下颌支段的侵犯情况,并对两种方法中神经侵犯的显示情况进行等级评分和统计分析。结果:3D-FIESTA序列和增强FSPGR序列T1WI均能较好显示脑池段三叉神经的侵犯(P>0.05)。对脑池段外(海绵窦、圆孔、卵圆孔、翼腭窝和咀嚼肌间隙)三叉神经受侵的显示,增强FSPGR序列优于3D-FIESTA序列(P<0.05)。三叉神经及其分支受侵在增强FSPGR序列上表现为明显强化肿块影,低信号结节以及边缘强化、中央呈低信号的"靶环样"结节改变;3D-FIESTA序列上主要表现为低信号结节或肿块影,以及神经孔道不规则扩大,其内见低信号软组织影。结论:3D-FIESTA序列能较好显示受侵犯的脑池段三叉神经,但在脑池段外三叉神经侵犯的显示上不及增强FSPGR序列,两种方法联合应用有助于更好地显示各段三叉神经的侵犯情况。Objective：To assess the value of MR imaging in the demonstration oi the invasion of trigemmat nerve in head and neck neoplasms by using three dimensional fast employing steady-state acquisition sequence （3D-FIESTA sequence） and enhanced FSPGR sequence with fat-saturation T1-weighted imaging. Methods：Twenty-two patients with the symptom of impairment of trigeminal nerve underwent 1.5T MR examination by using the 3D-FIESTA sequence and enhanced FSPGR sequence with fat-saturation T1-weighted imaging. The visibility of invasion of trigeminal nerve in six segments including cisternal,cavernous sinus, pterygopalatine fossa, foramen rotundum, foramen ovale and masticatory muscle space were observed and evaluated. Results：The invasion of trigeminal nerve in intracisternal segment was well visualized by using two sequences and there was no statistic difference （P〉0.05）. For the visualization of invasion of trigeminal nerve out of cisternal segment by using enhanced FSPGR sequence was better than that by using 3D FIESTA sequence （P〈0.05）. On the T1-weighted image by using FSPGR sequence the invaded trigeminal nerve manifested irregular hyperintense mass or nodular mass, hypointense node or the ＂target＂ sign--high signal margin with low signal in center. On the image by using 3D FIESTA sequence the invaded trigeminal nerve presented a hypointense node or mass and irregular enlargement of foramen showed as a hypointense mass instead of normal fat signal Conclusion：The normal and invasion of trigeminal nerves in cisternal segment are easily visualized by using the 3D FIESTA sequence without enhancement. But in visualization of the invasion of trigeminal nerve out of cisternal segments by using 3D FIESTA sequence without enhancement is inferior to that by using enhanced FSPGR sequence. A combination of the two sequences is most useful for the evaluation of invasion of trigeminal nerve in all courses.

关 键 词：头颈部肿瘤 磁共振成像 三叉神经 

分 类 号：R739.91[医药卫生—肿瘤]