磁共振3D-T1WI序列在新生儿局灶性脑白质损伤病灶检出中的应用  

The application of three-dimensional T1 weighted imaging for detecting neonatal punctate white matter lesions

作　　者：孙亲利[1,2] 张育苗 高洁[1] 宁宁[1] 王苗苗[1] 李彦彦[1] 李欢[1] 杨健[1,2] SUN Qin-li;ZHANG Yu-miao;GAO Jie;Ning Ning;WANG Miao-miao;LI Yan-yan;LI Huan;YANG Jian(Department of Radiology,the First Affiliated Hospital of Xi＇an Jiaotong University,Xi＇an 710061;Department of Biomedical Engineering,School of Life Science and Technology,Xi＇an Jiaotong University,Xi＇an 710054,China)

机构地区：[1]西安交通大学第一附属医院医学影像科,西安710061 [2]西安交通大学生命科学与技术学院生物医学工程系,西安7100540

出　　处：《磁共振成像》2018年第11期801-806,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家重点研发计划项目(编号:2016YFC0100300);国家自然科学基金面上项目(编号:81471631;81771810;81171317);2011年教育部"新世纪优秀人才支持计划"项目(编号:NCET-11-0438);陕西省自然科学基金青年项目(编号:2017JQ8005);西安交通大学第一附属医院临床研究课题重点项目(编号:XJTU1AF-CRF-2015-004);青年创新基金(编号:2011YK.19)~~

摘　　要：目的比较磁共振三维T1加权成像(three-dimensional T1 weighted imaging,3D-T1WI)序列与常规T1加权成像(T1weightedimaging,T1WI)、T2加权成像(T2 weighted imaging,T2WI)及磁共振成像新技术(磁共振扩散成像及磁敏感加权成像)在新生儿局灶性脑白质损伤(punctate white matter lesions,PWML)病灶检出中的差异,评价3D-T1WI序列在新生儿颅脑磁共振检查中的价值。材料与方法研究对象为2011年3月至2013年2月在我院GE 3.0 T磁共振设备行颅脑MRI检查诊断为PWML的新生儿。扫描序列包括3D-T1WI(FSPGR序列)、T2WI、扩散张量成像(diffusion tensor imaging,DTI)及磁敏感加权成像(3D-enhanced susceptibility-weighted angiography,ESWAN)。分别观察3D-T1WI、重建T1WI(3D-T1WI重建的4mm图像)、常规T2WI、DTI后处理的表观扩散系数(apparent diffusion coefficient,ADC)图及ESWAN后处理的幅度(Magnitude)图,比较各序列图像对PWML病例数及病灶数检出的差异。结果 (1) 84例PWML病例,3D-T1WI、重建T1WI、常规T2WI、ADC图和Magnitude图检出PWML病例数分别为84(100%)、69(82.14%)、71(84.52%)、73(86.90%)和70(83.33%)。(2)3D-T1WI、重建T1WI、常规T2WI、ADC图和Magnitude图对可计数之53例PWML病例检出的病灶总数分别为422、151、185、142和152。3D-T1WI与其他各序列检出PWML病灶数两两比较有明显统计学差异(P<0.001)。与3D-T1WI比较,重建T1WI、常规T2WI、ADC图及Magnitude图对53例PWML病灶的检出率分别为35.78%(151/422)、43.84%(185/422)、33.65%(142/422)、36.02%(152/422)。结论 3D-T1WI序列对PWML病例及病灶的检出率均高于常规T1WI、T2WI及磁共振新技术(ADC图、Magnitude图),可作为新生儿颅脑MR检查的常规序列。Objective： To compare the different for detecting neonatal punctate white matter lesions between three dimensional T1 weighted imaging （3D T1WI） and conventional MRI, diffusion imaging and susceptibility-weighted imaging, and to assess the value of 3D-T1WI sequence in the brain MR examination for neonates. Materials and Methods： Between March 2011 and February 2013, neonates with PWML underwent 3.0 T MRI exam were recruited. The routine protocol included 3D T1WI, T2 weighted imaging （T2WI）, diffusion tensor imaging （DTI） and 3D enhanced susceptibility weighted angiography （ESWAN）. Reformatted T1WI （4 mm）, apparent diffusion coefficient （ADC） map and magnitude image were obtained from 3D-T1WI, DTI and ESWAN, respectively. The numbers of PWML cases and lesions were calculated in all images independently. Results： （1） The number of cases that identified by 3D-T1WI, reformatted T1WI, T2WI, ADC maps and magnitude maps were 84 （100%）, 69 （82.14%）, 71 （84.52%）, 73 （86.90%） and 70 （83.33%）, respectively. （2） For 53 cases whose lesions can be counted, the total number of lesions detected by 3D T1WI, reformatted T1WI, T2WI, ADC maps and magnitude maps were 422, 151, 185, 142 and 152, respectively. There are significant difference of the detectivity of punctate lesions between 3D T1WI and other MRI sequences （P〈0.001）. Comparing to 3D T1WI, the detection rate of reformatted T1WI, T2WI, ADC maps and magnitude maps was 35.78% （151/422）, 43.84% （185/422）, 33.65% （142/422）, 36.02% （152/422）, respectively. Conclusions： The detection rate of punctate lesions in 3D T1WI is higher than that in other MRI sequences. It is greatly recommended to use 3D T1WI as a routine sequence for neonatal brain MR examination.

关 键 词：新生儿 局灶性脑白质损伤 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]