磁共振脑容积成像对颈静脉球瘤脑膜侵犯的诊断价值  

Diagnostic Value of MR BRAVO Sequence in Meningeal Invasion of Glomus Jugulare Tumor

作　　者：毛铭阳 苏童 冯国栋 田旭[3] 徐振潭 陈钰[1] 张竹花[1] 高志强[3] 金征宇[1] MAO Mingyang;SU Tong;FENG Guodong(Department of Radiology,Peking Union Medical College Hospital,Chinese Acadamy of Medical Sciences&Peking Union Medical College,Beijing 100730,P.R.China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院放射科,北京100730 [2]青岛大学附属青岛市第三人民医院放射科,266000 [3]中国医学科学院北京协和医学院北京协和医院耳鼻喉科,北京100730

出　　处：《临床放射学杂志》2022年第4期612-617,共6页Journal of Clinical Radiology

基　　金：国家自然科学基金资助项目(编号:82001814)。

摘　　要：目的评价颈静脉球瘤患者增强MRI脑容积成像(BRAVO)序列的图像质量及对脑膜侵犯程度的诊断价值。方法回顾性分析经手术病理证实的颈静脉球瘤患者的颞骨增强MRI BRAVO序列及增强T_(1)WI快速自旋回波(FSE)序列的影像资料,评估两种增强序列的图像伪影。分别测量两种增强序列上肿瘤最大层面及同层面脑干的信号强度(SI)及标准差(SD)。计算肿瘤的信噪比(SNR)及对比噪声比(CNR)。根据Fisch分型标准评估两种增强序列的术前影像D分型,并通过手术及病理资料获得手术D分型。比较两种增强序列的伪影评分、SNR、CNR的差异,以及影像D分型与手术D分型的差异。对照手术D分型,分析两种增强序列对侵犯脑膜及突破脑膜的诊断效能。结果共纳入24例患者,增强BRVAO序列的伪影评分优于增强FSE序列(P<0.01)。增强BRAVO序列的SNR及CNR的中位数均高于增强FSE序列的中位数(P<0.05)。增强BRVAO序列的D分型与手术D分型无统计学差异(P=0.317),增强BRVAO序列诊断侵犯脑膜及突破脑膜的准确性(0.958,1.000)均高于增强FSE序列(0.875,0.792)。结论增强BRAVO序列的图像质量及评估颈静脉球瘤侵犯脑膜及突破脑膜的准确性均高于常规增强FSE序列。Objective To evaluate the image quality and the diagnostic value of enhanced brain volume imaging(BRAVO)sequence for meningeal invasion in patients with glomus jugulare tumor(GJT).Methods Patients with GJT received temporal bone enhanced BRAVO sequence and conventional T_(1) weighted fast spin echo(FSE)sequence were retrospectively collected.All the patients were confirmed by surgery and pathology.The artifact scores of the two enhanced sequences were evaluated.The signal intensity(SI)and standard deviation(SD)of the tumors based on BRAVO and FSE sequences were measured respectively.The signal to noise ratio(SNR)and contrast to noise ratio(CNR)of the tumor were calculated.The meningeal invasion type of the two enhancement sequences based on Fisch D classification criteria was evaluated preoperatively and named as imaging D-type.The surgical D-type was obtained according to surgical and pathological records.The difference of artifact score,SNR and CNR between the two enhancement sequences were compared.The difference of D-type between imaging D-type and surgical D-type were compared.Taking surgical D-type as the gold standard,the diagnostic efficacy of the two enhancement sequences for meningeal invasion and breakthrough was analyzed.Results A total of 24 patients were included.Enhanced BRAVO sequence had better artifact scores compared with enhanced FSE sequence(P<0.01).The median of SNR and CNR of enhanced BRAVO sequence were higher than that of enhanced FSE sequence(P<0.05).There was no significant difference in D-type between enhanced BRAVO sequence and surgical results(P=0.317).The accuracy of enhanced BRAVO sequencewere 0.958 and 1.000,which were higher than that of enhanced FSE sequence(0.875,0.792).Conclusion The enhanced BRAVO sequence of GJT could show better image quality and accuracy ifevaluation of invasion and breakthrough of meninges are required.

关 键 词：颈静脉球瘤 磁共振成像 分型 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.91[医药卫生—诊断学]