磁共振STIR-FLAIR序列对视神经炎的诊断价值初探  

STIR-FLAIR MR sequence for the imaging evaluation of optic neuritis:a polite study

作　　者：许庆刚[1] 刘云福[1] 代飞飞[2] 牛延涛[1] 鲜军舫[1] XU Qing-gang;LIU Yun-fu;DAI Fei-fei(Department of Radiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院放射科,北京100730 [2]首都医科大学附属北京同仁医院神经内科,北京100730

出　　处：《中日友好医院学报》2022年第4期203-206,220,共5页Journal of China-Japan Friendship Hospital

基　　金：北京市医管局临床医学发展专项(杨帆计划)(ZYLX201704);北京市医院管理中心“登峰”计划专项(DFL20190203)。

摘　　要：目的:探讨联合应用短时间反转恢复-液体衰减反转恢复序列(STIR-FLAIR)对视神经炎的诊断价值。方法:对28例(男9例,女19例)视神经炎患者和10例健康志愿者进行磁共振扫描,并采集数据。所有受试者均在诊断视神经炎后4周~6个月内进行磁共振检查,扫描序列包括冠状面STIR,STIR FLAIR和增强T1WI,对视神经病变受累的不同部位、范围及信号变化、信噪比等进行客观评价。结果:STIR及STIR-FLAIR序列显示视神经内的有效病变(高信号)一致性良好(κSTIR=0.80,κSTIR-FLAIR=0.86)。STIR-FLAIR序列显示视神经病变范围比STIR序列显著增大,差异有统计学意义(分别为15.9±8.7mm和12.7±7.9mm,P<0.05)。与STIR序列相比较,STIR-FLAIR序列视神经病变的相对值、视神经炎病变的信号强度/同侧眼眶眶内脂肪信号强度及视神经炎病变的信号强度/对侧视神经信号强度的差异均有统计学意义(P<0.05)。结论:STIR FLAIR序列对于诊断视神经炎更具敏感性,具有较高的临床应用价值。Objective:To investigate the optic nerve signal abnormality in patients with optic neuritis(ON)employing short time inversion recovery fluid-attenuated inversion recovery(STIR-FLAIR).Methods:MR imaging was performed and data were collected with a 3.0 T unit in 10 healthy volunteers and 28 patients with ON confirmed by visual-evoked potentials that were used as the reference. Imaging was performed between 4weeks and 6 months after the diagnosis.Coronal images were obtained throughout the course of optic nerve scan with STIR,STIR-FLAIR and T1WI+C sequences.All images were evaluated and compared concerning the presence of optic nerve lesions,lesion lengths,and signal intensities in different anatomical parts of the optic nerves and CNR measures.Results:Interobserver agreements regarding the detection of optic nerve lesions were excellent for both sequences(κSTIR=0.80,κSTIR-FLAIR=0.86).Greater extensions(15.9±8.7mm vs. 12.7±7.9mm)were detected on STIR-FLAIR compared with STIR sequences(P<0.05).The relative signal intensity and CNR ratios of lesions’ mean signal intensities vs. ipsilateral surrounding orbital fat and vs. signal intensity measurements from contralateral optic nerves were significantly higher on STIR-FLAIR compared with STIR(P<0.05 for both comparisons).Conclusion:STIR-FLAIR sequence appears to be more sensitive for the detection of hyperintense optic lesions and to be more useful in patients suspected ON.

关 键 词：视神经炎 磁共振成像 STIR FLAIR 对比增强 

分 类 号：R445.2[医药卫生—影像医学与核医学]