颅颈部高分辨率MRA:常规黑血序列与SNAP序列的比较  

Comparison of simultaneous non-contrast angiography and intraplaque hemorrhage imaging with conventional black blood technique in the high resolution craniocervical artery imaging

作　　者：陆艳[1] 黄仁军[1] 李勇刚[1] LU Yan;HUANG Ren-jun;LI Yong-gang(Department of Radiology,the First Affiliated Hospital of Soochow University,Jiangsu 215123,China)

机构地区：[1]苏州大学附属第一医院放射科

出　　处：《放射学实践》2019年第8期863-868,共6页Radiologic Practice

基　　金：2018年度苏州市临床重点病种诊疗技术专项(LCZX201801)

摘　　要：目的:比较非对比增强血管和斑块内出血同时成像(SNAP)序列与常规黑血(BB)序列在颅颈动脉(CCA)成像中的图像质量,探讨SNAP序列的临床实用性。方法:对45例患者行颅颈动脉高分辨率MRI检查,扫描序列包括SNAP、T1WI-BB、T2WI-BB及容积采集各向同性快速自旋回波质子加权成像(PDWI-VISTA)。分别在各序列图像上测量和计算管腔及管壁的信噪比(SNR)、管壁与管腔信号差异噪声比(SDNR)及管壁与管腔的对比噪声比(CNR)。对诊断为颈内动脉夹层壁内血肿(IMH)的20例患者按照上述方法计算壁内血肿的SNR及壁内血肿与管腔的SDNR和CNR。采用单因素方差分析和Student-Newman-Keulsq检验对4个序列的上述各项测量指标分别进行两两比较。结果:(1)SNAP序列与T1WI-BB、T2WI-BB及PDWI-VISTA序列之间的管腔SNR、管壁SNR、管壁与管腔SDNR的差异均具有统计学意义(P<0.001),而与其它序列的管壁与管腔CNR的差异无统计学意义(P=0.014);(2)两两比较发现SNAP序列的管腔和管壁SNR与其它3个序列间的差异具有统计学意义(P<0.05);(3)20例有壁内血肿的患者壁内血肿SNR及血肿与管腔CNR在SNAP序列与其它3个序列之间具有显著的统计学差异(SNR:P<0.001;CNR:P<0.001),而壁内血肿与管腔SDNR的差异无统计学意义(P=0.048),但血肿与管腔SDNR在SNAP序列中均值最高;(4)两两比较发现血肿SNR及血肿与管腔CNR在SNAP序列与其它3种序列之间差异均有统计学意义(P<0.05)。结论:虽然SNAP序列能够清晰显示管壁及管腔结构,但管壁与管腔对比度不及T1WI-BB序列;而SNAP序列在识别壁内血肿方面较其它3个序列具有优势。Objectives:To investigate the clinical application of simultaneous non-contrast angiography and intraplaque hemorrhage(SNAP)compared with conventional black blood technology.Methods:45 patients received high resolution magnetic resonance imaging of the craniocevical artery using sequences including SNAP,T 1WI-BB(T 1-weighted imaging-black blood),T 2WI-BB(T 2-weighted imaging-black blood)and proton density weighted imaging-volume isotropic turbo-spin-echo acquisition(PDWI-VISTA).The signal to noise ratio(SNR)of wall and lumen,the signal difference to noise ratio(SDNR)and contrast noise ratio(CNR)of wall to lumen were separately calculated.The single factor variance analysis and q-test(Student-Newman-Keuls method)were used to compare the SNR and SDNR respectively between any two sequences.As per the 20 patients that definitely displayed intramural hematoma,signal to noise ratio(SNR),the signal difference to noise ratio(SDNR)and the contrast noise ratio(CNR)were calculated.The single factor variance analysis and q-test(Student-Newman-Keuls method)were used to compare the SNR and CNR of hematoma to lumen between any two sequences.Results:①The SNR of wall and lumen and SDNR of wall to lumen were found to have significant statistical difference among SNAP,T 1WI-BB,T 2WI-BB and PDWI-VISTA(lumen SNR:P<0.001;wall SNR:P<0.001;wall to lumen SDNR:P<0.001);there were no significant statistical difference about wall-lumen CNR of T 1WI-BB,T 2WI-BB and PDWI-VISTA(P=0.014).②The SNR of arterial wall and lumen of SNAP sequence was found to have significant difference compared with the other three sequences by use of pair-wise comparison(all P<0.05).③As per the 20 patients with intramural hematoma,the hematoma SNR and CNR of the hematoma to the lumen showed obvious statistical difference among the above four sequences(hematoma SNR:P<0.001;hematoma to lumen CNR:P<0.001),there were no obvious statistical difference of the SDNR of hematoma to lumen(P=0.048),but it had the highest mean value in SNAP sequence.④The hematoma SNR an

关 键 词：磁共振成像 高分辨率 血管成像 头颈动脉 壁内血肿 

分 类 号：R445.2[医药卫生—影像医学与核医学] R543.4[医药卫生—诊断学]