SEMAC-VAT去金属伪影技术用于3D打印人工椎体脊柱重建术后成像的价值  

The value of SEMAC-VAT imaging in the post-operative imaging of spine reconstruction surgery with 3D-printed vertebral body

作　　者：赵强[1] 孙兴文 张立华[1] 叶凯 韩嵩博[1] 欧阳汉强 袁慧书[1] ZHAO Qiang;SUN Xingwen;ZHANG Lihua;YE Kai;HAN Songbo;OUYANG Hanqiang;YUAN Huishu(Department of Radiology,Peking University Third Hospital,Beijing 100191,China;Department of Orthopaedics,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院放射科,北京100191 [2]北京大学第三医院骨科,北京100191

出　　处：《磁共振成像》2023年第1期130-135,共6页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的探索层面编码金属伪影校正结合视角倾斜(slice-encoding metal artifact corrections-view-angle tilting,SEMAC-VAT)技术能否减少3D打印人工椎体脊柱重建术术后成像中金属伪影的影响。材料与方法于2020年3月至2020年9月期间在北京大学第三医院前瞻性招募了17名行3D打印人工椎体脊柱重建术的患者行T2加权SEMAC-VAT序列及T2加权快速自旋回波(turbo-spin-echo,TSE)序列成像。由两名影像诊断医师对图像进行评估对比,包括:金属伪影大小、信噪比(signal-to-noise ratio,SNR),以及人工椎体周围关键解剖结构的可见度。变量的对比采用配对样本t检验、独立样本t检验以及秩和检验。采用Kappa系数评估观察者间一致性。结果与T2加权TSE序列相比,SEMAC-VAT序列可以显著减小伪影的前后径[(3.1±7.5)mm vs.(9.0±9.1)mm,P<0.01]和上下径[(4.8±6.3)mm vs.(15.4±14.5)mm,P<0.01],显著提高人工椎体周围椎间孔、神经根,以及骨-金属交界的可见度(P均<0.05)。椎管的可见度在两种序列中可见度相当(P=1.000)。SEMAC-VAT序列的图像SNR显著低于TSE序列(P均<0.05)。结论在3 T MRI中,SEMAC-VAT序列成像可以有效减轻3D打印金属椎体伪影,可改善大部分3D打印人工椎体周围解剖结构可见度,可能有助于提高3D打印人工椎体脊柱重建术术后MRI的诊断效能。Objective:To explore the value of slice-encoding metal artifact corrections-view-angle tilting(SEMAC-VAT)sequences in the post-operative imaging of spine reconstruction surgery with a 3D-printed vertebral body(VB).Materials and Methods:Seventeen patients with 3D-printed VB underwent spinal MRI with T2 turbo-spin-echo(TSE)and T2-weighted SEMAC-VAT sequences.The evaluation was performed by two musculoskeletal radiologists by assessing the artifact size,the signal-to-noise ratio(SNR),and the visibility of the critical anatomical structures close to metal implants.Paired t tests,independent t tests,and Wilcoxon signed-rank tests were used for comparisons,and Kappa values were used for interobserver agreement.Results:SEMAC-VAT images demonstrated significantly reduced longitudinal[(4.8±6.3)mm vs.(15.4±14.5)mm,P<0.01]and anterior-posterior[(3.1±7.5)mm vs.(9.0±9.1)mm,P<0.01]diameters of the artifacts and improved visibility of the periprosthetic anatomical structures compared with conventional TSE images.The visibility of the spinal canal is comparable between TSE and SEMAC-VAT images.SNRs of the periprosthetic anatomical structures in SEMAC-VAT images are significantly lower than in TSE images.Conclusions:SEMAC-VAT imaging could reduce the size of the metal artifact and improve the visibility of most periprosthetic anatomical structures in patients after spine reconstruction surgery using a 3D-printed VB.SEMAC-VAT imaging may thus improve the diagnostic efficacy of post-operative imaging of spine reconstruction surgery with a 3D-printed VB.

关 键 词：脊柱恶性肿瘤 全脊椎切除术 人工椎体 伪影 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.53[医药卫生—诊断学]