磁共振增强CUBET_(1)WI序列检出肺癌脑转移微小病灶效能的研究  

MRI enhanced CUBE T1WI sequence for diagnosis of lung cancer brain metastasis

作　　者：李丽红[1] 朱华勇[1] 李欣[1] 吴玲 李杨飞[1] 林双翔 丁建荣[1] LI Lihong;ZHU Huayong;LI Xin;WU Lin;LI Yangfei;LIN Shuangxiang;DING Jianrong(Department of Radiology,Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University,Taizhou 317000,China)

机构地区：[1]浙江省台州医院放射科,317000

出　　处：《浙江医学》2021年第19期2104-2108,共5页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技面上项目(2019ky777);台州市科技计划项目(1902ky30)。

摘　　要：目的探讨磁共振增强各向同性三维快速自旋回波脉冲(CUBE)T_(1)WI序列检出肺癌脑转移微小病灶的效能。方法对2018年1月至2019年12月浙江省台州医院20例临床怀疑肺癌脑转移患者均先行常规头颅磁共振平扫序列,再采用矢状位增强CUBE T_(1)WI序列和常规增强SE T_(1)WI序列(横断面、矢状面、冠状位)扫描。对两种增强扫描序列采集得到的图像进行分析,利用Mann-Whitney U检验评价2位医师对图像质量评分的差异性;采用Wilcoxon检验比较颅脑常规增强SE T_(1)WI序列和增强CUBE T_(1)WI序列检出转移病灶个数的差异。结果2位医师对颅脑常规增强SE T_(1)WI、CUBE T_(1)WI序列图像质量评价的差异均无统计学意义(P=0.825、0.275);增强CUBE T_(1)WI序列图像显示的病灶数173个,其中病灶直径<3 mm为52个、3~8 mm为92个、>8 mm为29个;常规增强SE T_(1)WI序列图像显示的病灶数141个,其中病灶直径<3 mm为24个、3~8 mm为89个、>8 mm为28个,增强CUBE T_(1)WI序列对病灶直径<3 mm的微小病灶检出能力明显高于常规增强SE T_(1)WI序列,差异有统计学意义(P=0.007),但对3~8 mm和>8 mm的检出能力差异均无统计学意义(P=0.083、0.655)。结论在显示肺癌脑转移微小病灶方面增强CUBE T_(1)WI序列比常规增强SE T_(1)WI序列更敏感,对发现肺癌患者早期脑内转移病灶有一定的临床应用价值,可替代常规增强SE T_(1)WI序列应用于临床。Objective To explore the clinical value of MRI enhanced CUBE T_(1)WI sequence in diagnosis of lung cancer brain metastases.Methods Twenty lung cancer patients with suspected brain metastasis undergoing MRI examination in Taizhou Hospital between January 2018 to December 2019 were enrolled in the study.All patients underwent conventional cranial MR scanning sequences,then received intravenous injection of double dose(0.2 mmol/kg)meglumine gadopentetate(GD-DTPA),and underwent enhanced MR scanning.Sagittal enhanced CUBE T_(1)WI sequence and conventional enhanced SE T_(1)WI(axial,sagittal,coronal)sequence scans were performed.The consistency of the image quality scores were evaluated with Mann-Whitney U test by two radiologists independently.Wilcoxon test was used to compare the number of lesions detected by conventional enhanced SE T_(1)WI and CUBE T_(1)WI.Results There were no significant differences in the quality assessment of routine enhanced SE T_(1)WI sequence images(P=0.825)and enhanced CUBE T_(1)WI sequences(P=0.275)between two radiologists.The enhanced CUBE T_(1)WI sequence images showed 173 brain metastatic lesions,including 52 lesions with diameter<3 mm,92 lesions with diameter 3-8 mm,and 29 lesions with diameter>8 mm.The conventional enhanced SE T_(1)WI sequence images showed 141 brain metastatic lesions,including 24 lesions with diameter<3 mm,89 lesions with diameter 3-8 mm,and 28 lesions with diameter>8 mm.The enhanced CUBE T_(1)WI sequence showed more metastatic lesions than the conventional enhanced SE T_(1)WI sequence(P=0.007).The enhanced CUBE T_(1)WI sequence was significantly better than the conventional enhanced SE T_(1)WI sequence in the detection of small lesions with lesion diameter<3 mm(P=0.007).There was no significant difference in the detection ability of lesions with diameter of 3-8 mm and 8 mm between two methods(P=0.083 and P=0.655).Conclusion The enhanced CUBE T_(1)WI sequence is more sensi-tive than the conventional enhanced SE T_(1)WI sequence in displaying small brain metastases of

关 键 词：磁共振成像 各向同性三维快速自旋回波脉冲T_(1)WI 序列 肺癌 脑转移 

分 类 号：R445.2[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学]