3.0T MRI 3D Space序列对颅脑动脉斑块出血的诊断应用  

Application of 3.0tmri 3D space sequence in the diagnosis of cerebral arterial plaque hemorrhage

作　　者：于慧芳 刘冰[1] YU Huifang;LIU Bing(Imaging Center Department, First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471000, P.R.China)

机构地区：[1]河南科技大学附属第一医院影像中心,河南洛阳471000

出　　处：《医学影像学杂志》2022年第1期16-20,共5页Journal of Medical Imaging

摘　　要：目的探讨磁共振可变翻转角的三维快速自旋回波(3D-sampling perfection with application optimized contrast using different flip angle evolutions,3D-SPACE)序列检测大脑中动脉斑块内出血(intraplaque hemorrhage,IPH)的成像情况及其诊断价值。方法选取我院就诊的脑动脉粥样硬化的患者100例,所有患者均接受常规MRI检查、3D序列亮血时飞法MR血管成像(time-of-flight magnetic resonance angiography,TOFMRA),同时接受3D-SPACE序列检查。根据常规序列(T1WI、T2WI、3D TOF、T1WI-CE)图像综合评估IPH,并根据患者的临床、影像学结果对所有患者进行评估,将患者分为有症状组和无症状组。对比两组患者3D-SPACE序列评估斑块信号的高低情况,同时对比3D-SPACE及常规MRI各序列对IPH的评估效果。结果有症状组72例患者中通过3D-SPACE序列共检测出142个斑块,其中斑块病灶信号强化2级98个(69.1%),仅11个(7.7%)斑块无信号强化;无症状组28例患者中共检测出49个斑块,其中35个斑块(71.5%)表现为无强化或1级强化。有症状组患者中IPH的发生率显著高于无症状组,同时有症状组患者中3D-SPACE序列信号强化程度显著高于无症状组,差异具有统计学意义(P<0.05)。评估191个斑块中共有112个为IPH,结果提示TOF、T1WI、3D-SPACE序列评估IPH具有较高的敏感性、特异性和一致性,其中3D-SPACE显示IPH的一致性最高。结论3.0T MRI 3D-Space序列能够有效的提示MCA粥样斑块的IPH情况,为合并颅内血管脑动脉斑块患者的危险程度评估及治疗提供参考依据,具有较高的诊断和临床价值。Objective To investigate the imaging and diagnostic value of MRI 3D-space sequence in the detection of middle cerebral artery IPH.Methods 100 patients with cerebral atherosclerosis who came to our hospital from June 2019 to June 2021 were selected.All patients underwent routine MRI,3D-TOF and 3D-space sequence.IPH was comprehensively evaluated according to conventional sequence(T1WI,T2WI,3D-TOF,T1WI-CE)images,and all patients were evaluated according to the clinical and imaging results.The patients were divided into symptomatic group and asymptomatic group.The plaque signals of the two groups were evaluated by 3D-space sequence,and the evaluation effects of 3D-space and conventional MRI sequences on IPH were evaluated and compared.Results 142 plaques were detected by 3D-space sequence in 72 patients in the symptomatic group,of which 98(69.1%)had grade 2 plaque signal enhancement,and only 11(7.7%)had no signal enhancement;A total of 49 plaques were detected in 28 patients in the asymptomatic group,of which 35 plaques(71.5%)showed no enhancement or grade 1 enhancement.The incidence of IPH in symptomatic group was significantly higher than that in asymptomatic group.At the same time,the signal enhancement degree of 3D-space sequence in symptomatic group was significantly higher than that in asymptomatic group(P<0.05).In this study,112 of 191 plaques evaluated by two doctors were IPH.The results showed that TOF,T1WI and 3D-space sequences had high sensitivity,specificity and consistency in the evaluation of IPH,among which 3D-space showed the highest consistency.Conclusion 3.0T MRI 3D-space sequence can effectively prompt the IPH of MCA atherosclerotic plaque,and provides a reference basis for risk assessment and treatment of patients with intracranial vascular and cerebral artery plaque,and has high diagnostic and clinical value.

关 键 词：大脑中动脉 斑块内出血 3D Space序列 高分辨率磁共振成像 

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]