三维可变翻转角快速自旋回波序列术前评估听神经瘤  

Three-dimensional sampling perfection with application optimized contrasts using different flip angle evolutions sequence in preoperative evaluation of acoustic neuroma

作　　者：汪倩倩 曾少华 洪桂洵[3] 饶良俊[3] 初建平[3] 杨智云[3] WANG Qianqian;ZENG Shaohua;HONG Guixun;RAO Liangjun;CHU Jianping;YANG Zhiyun(Department of Medical Imaging,Taishan People＇s Hospital,Taishan 529200,China;Department of Medical Imaging,Qingyuan People＇s Hospital,Qingyuan 511518,China;Department of Medical Imaging,the First Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510080,China)

机构地区：[1]台山市人民医院医学影像科,广东台山529200 [2]清远市人民医院医学影像科,广东清远511518 [3]中山大学附属第一医院医学影像科,广东广州510080

出　　处：《中国医学影像技术》2018年第6期841-845,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察三维可变翻转角快速自旋回波(3D-SPACE)序列术前评估听神经瘤的价值。方法收集经手术病理证实的听神经瘤患者57例,术前均接受脑部常规MR及3D-SPACE序列检查,观察3D-SPACE序列显示肿瘤位置、大小、形态等,评估其对相邻脑神经的显示率,并与常规MRI及手术所见相对照。结果57例患者肿瘤均为单发,1例(1/57,1.75%)局限于内听道内,56例(56/57,98.25%)超出内听道口生长;26例(26/57,45.61%)充满内听道底,31例(31/57,54.39%)未充满内听道。57例中,3D-SPACE序列显示实质型肿瘤21例(21/57,36.84%),实质伴囊变型肿瘤35例(35/57,61.40%),囊型肿瘤1例(1/57,1.76%),与术中所见符合率为85.96%(49/57)。3D-SPACE序列对三叉神经脑池段、后组脑神经脑池段、展神经脑池段、面神经内听道段、面神经脑池段及听神经脑池段的显示率分别为100%(57/57)、100%(57/57)、75.44%(43/57)、50.88%(29/57)、17.53%(10/57)和19.30%(11/57),均高于常规MRI(P均<0.05)。结论3D-SPACE序列可准确显示肿瘤与相邻脑神经的关系,对于术前评估听神经瘤具有重要临床价值。Objective To investigate the clinical value of three-dimensional sampling perfection with application optimized contrasts using different flip angle evolutions（3D-SPACE）sequence in preoperative evaluation of acoustic neuroma.Methods Totally 57 patients with acoustic neuroma confirmed by surgery and pathology were enrolled.All patients underwent preoperative routine head MR and 3D-SPACE sequence.The position,size and shape of the tumors were observed,and the display rate of surrounding cranial nerves was evaluated with 3D-SPACE sequence.The results were compared with those of conventional MRI and operation.Results All 57 patients were found with single tumor.The tumor in 1 patient（1/57,1.75%）limited in the internal auditory canal,and those in another 56 patients（56/57,98.25%）exceed the internal auditory canal crossing growth.The inner auditory canal fundus in 26 patients（26/57,45.61%）were completely filled by the tumors,while those in another 31 patients（31/57）were uncompletely filled.3D-SPACE sequence showed 21 patients（21/57,36.84%）with solid type lesions,35 patients（61.40%,35/57）with solid with cystic type lesions and 1 patient（1/57,1.76%）with cystic type lesion.The coincidence rate of lesion types showed with 3D-SPACE sequence and intraoperative findings was 85.96%（49/57）.The display rate of trigeminal nerve internal cisternal segment,lower cranial nerves cisternal segment,abducens nerve cisternal segment,facial nerve internal acoustic meatus segment,facial nerve cisternal segment and acoustic nerve cisternal segment was 100%（57/57）,100%（57/57）,75.44%（43/57）,50.88%（29/57）,17.53%（10/57）and 19.30%（11/57）,respectively,all significantly increased compared with those of conventional MRI（all P〈0.05）.Conclusion 3D-SPACE sequence can accurately display the relationship between tumor and adjacent cranial nerves,therefore has important clinical value in preoperative evaluation of acoustic neuroma.

关 键 词：神经瘤 听 脑神经 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]