定量磁化率图对脑微出血铁含量动态变化的随访研究  

The dynamic changes of iron content in cerebral microbleeds on quantitative susceptibility mapping

作　　者：孙晓焕 刘延真 夏爽[3] 杨子权 刘黎明 马勇 付青 徐大勇 SUN Xiaohuan;LIU Yanzhen;XIA Shuang;YANG Ziquan;LIU Liming;MA Yong;FU Qing;XU Dayong(Department of Radiology,Tianjin Ninghe Hospital,Tianjin 301500,China;Department of Radiology,Tianjin Chest Hospital;Department of Radiology,First Central Hospital of Tianjin)

机构地区：[1]天津市宁河区医院放射科,天津301500 [2]天津市胸科医院放射科 [3]天津市第一中心医院放射科

出　　处：《国际医学放射学杂志》2021年第3期264-268,共5页International Journal of Medical Radiology

摘　　要：目的应用定量磁化率图(QSM)随访研究脑内微出血(CMB)病灶体积变化与磁敏感值变化之间的相关性,探讨CMB铁含量的动态变化。方法回顾性收集行头颅常规MRI序列及磁敏感加权成像(SWI)序列检查中具有明确CMB的病人资料,所有病人均进行了基线和随访检查(2次检查时间间隔约12个月)。共纳入病人35例,男27例,女8例,平均(67.94±9.57)岁。将SWI序列原始相位图和幅度图进行后处理得到QSM,在基线和随访QSM上手动勾画CMB的兴趣区(ROI),选取ROI内磁敏感值≥130ppb的CMB病灶,测量ROI内像素数作为CMB体积;同时在ROI上测量并记录CMB最大磁敏感值、平均磁敏感值。根据随访与基线CMB体积变化,将CMB病灶分为体积增大、体积减小及体积不变组。采用Spearman相关分析CMB体积与最大磁敏感值、平均磁敏感值的相关性。采用配对样本t检验比较不同组内基线及随访CMB的磁敏感值变化。结果共纳入CMB病灶322个,其基线QSM上所示病灶体积、最大磁敏感值、平均磁敏感值均高于随访QSM所见(均P<0.05)。基线及随访的CMB体积与最大磁敏感值、平均磁敏感值均呈正相关(均P<0.05)。根据随访与基线CMB体积变化,将病灶分为增大组108个、减小组198个、不变组16个。体积增大组随访水平的最大磁敏感值、平均磁敏感值均高于基线水平(均P<0.05);体积减小组随访水平最大磁敏感值、平均磁敏感值均低于基线水平(均P<0.05);体积不变组随访水平和基线水平的差异无统计学意义(均P>0.05)。结论随着时间的推移,CMB病灶体积、磁敏感值会发生变化。CMB磁敏感值的变化受体积变化的影响,间接反映CMB铁含量的动态变化。Objective Using quantitative susceptibility mapping(QSM)to study the correlation between the volume change and the change of magnetic susceptibility of intracerebral microbleeds(CMB),the dynamic change of iron content in CMB was explored.Methods A total of 35 patients with clear CMB who underwent routine MRI and susceptibility weighted imaging(SWI)were collected retrospectively,including 27 males and 8 females,with an average age of 67.94±9.57 years old.All patients underwent baseline and follow-up examination(the interval between the two examinations was about 12 months).QSM was generated after the post-processing of SWI original phase map and amplitude map.the regions of interest(ROIs)of CMB were manually delineated on baseline and follow-up QSM maps.The CMB lesions with magnetic susceptibility≥130 ppb in ROI were selected,and the pixel number in ROI was used as the volume of CMB.Meanwhile,the maximum magnetic sensitivity and average magnetic sensitivity of CMB were measured from each ROI.According to the volume changes of CMB between follow-up and baseline,the lesions were divided into enlargement group,decreased group,and unchanged group.The Spearman test method was used to analyze the correlation between the volume and the maximum and average magnetic susceptibilities of CMB.The change in magnetic sensitivity of CMB between baseline and follow-up images were tested by paired sample t test in each group.Results A total of 322 CMB were included.The volume,maximum magnetic and average magnetic sensitivities of CMB at baseline were higher than those of CMB at follow-up(all P<0.05).The volume of CMB was significantly positively correlated with both maximum and average magnetic sensitivities of CMB at both baseline and followup(all P<0.05).According to the volume changes of CMB between follow-up and baseline,the lesions were divided into enlargement group(108 cases),decreased group(198 cases),and unchanged group(16 cases).Both maximum and average magnetic sensitivities of CMB at follow-up were higher than those

关 键 词：脑微出血 定量磁化率图 磁共振成像 含铁血黄素 体积 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]