磁共振脑表面三维重建技术在脑表面病变定位中的价值探讨  

Localization of Brain Superficial Lesions with Three--dimensional MR Reconstruction

作　　者：包迎伟[1,2] 孙建忠[1] 付立平[2] 应红娟 龚向阳[1] 

机构地区：[1]浙江大学医学院附属第二医院放射科,浙江杭州310009 [2]浙江省遂昌县人民医院放射科

出　　处：《实用放射学杂志》2009年第8期1083-1086,共4页Journal of Practical Radiology

基　　金：浙江省卫生厅基金资助项目（20038080）.

摘　　要：目的评价磁共振脑表面三维重建技术在脑表面病灶精确定位诊断中的价值。方法病例共23例，其中肿瘤15例、陈旧脑梗塞软化病灶5例、血管畸形2例、脑发育畸形1例。使用容积重建技术进行磁共振脑三维重建并暴露脑表面结构。脑表面三维重建图像和二维多平面重建图像请2位有经验的放射诊断医师和2位年轻进修医师分别判读，对病灶累及的脑叶做出定位诊断。结果基于二维多平面重建图像，4位医师共认定23例病灶累及脑回（沟）118个，其中定位一致的脑回（沟）8个（6．78％），仅有1位医师认定的脑回（沟）51个（43．22％）；基于脑表面三维重建图像，共认定脑回（沟）93个，定位一致的脑回（沟）16个（17．2％），仅有I位医师认定的脑回（沟）28个（30．11％），差异有统计学意义。2位有经验医师分别基于二维多平面重建图像和脑表面三维重建图像进行病灶定位诊断时，定位一致的比例从50％提高到59．7％；2位年轻进修医师分别基于二维多平面重建图像和脑表面三维重建图像进行病灶定位诊断时，定位一致的比例从16．4％提高到32．1％，后者差异有显著性。结论脑表面三维重建技术能清楚显示病灶位置及其与脑沟、脑回的关系。Objective To evaluate the value of MR three-dimensional images in localization of brain lesions. Methods 23 patients were included in this study. MR images obtained with 3D flash sequence were reconstructed at workstation using volume rendering. Both 3D and 2D images were respectively evaluated by 2 experienced radiologists and 2 junior doctors. Locations and extensions of these lesions were recorded. Results Totally 118 gyri in 23 cases were considered to be involved by the lesions by 4 doctors respectively. Of that, there were 8（ 6.78 ~//00~ gyri regarded unanimously by all 4 doctors and 51（43.22%） gyri by only one doctor on 2D orthogonal images. Totaily 93 gyri in 23 cases were considered to be involved by the lesions by 4 doctors respectively. Whereas, . there were 16（17.2 % ） gyri involved by lesions regarded unanimously by all doctors and 28（30.11%） gyri by only one doctor based on 3D reconstructed images. Distinct differentiation could be found after statistically analyzed. Localization recorded by 2 experienced radiologists and 2 junior doctors based on 2D and 3D images respectively shows concordance rate increased from 50% （2D） to 59.7% （3D） in the group 6f experieneed radiologists. For 2 junior doctors, concordance rate increased from 16.4 %（2D} to 32.1 %（3D）. Conclusion MR three-dimensional reconstruction of brain surface can well show the lesions and the relationships between lesions and brain structures.

关 键 词：脑 磁共振成像 三维重建 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]