7T超高场MRI对多发性硬化病灶的检出价值  

Value of 7T ultra-high field MRI in the detection of multiple sclerosis lesions

作　　者：刘欣瑶 苏磊[2] 张喆 金奥铭 毕京凤 魏宁 田德财 荆京 LIU Xinyao;SU Lei;ZHANG Zhe;JIN Aoming;BI Jingfeng;WEI Ning;TIAN Decai;JING Jing(Tian Tan Neuroimaging Center Of Ercellence,China National Clinical Research Center for Neurological Diseases,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院国家神经系统疾病临床医学研究中心天坛神经影像研究中心,北京市100070 [2]天津医科大学总医院神经内科 [3]首都医科大学附属北京天坛医院国家神经系统疾病临床医学研究中心 [4]首都医科大学附属北京天坛医院神经病学中心

出　　处：《中国煤炭工业医学杂志》2023年第6期576-582,共7页Chinese Journal of Coal Industry Medicine

基　　金：国家自然科学基金资助(编号:82271329)。

摘　　要：目的分析比较颅脑7T MRI相对于指南指导下3T MRI对多发性硬化(MS)病灶的检出价值。方法前瞻性纳入2021年9月—2023年10月期间于首都医科大学附属北京天坛医院就诊的多发性硬化患者,所有入组患者符合2017年修订版McDonald MS诊断标准。收集患者的临床信息,并在住院期间完成3T及7T颅脑MRI检查。3T及7T颅脑MRI检查序列均包括T1 WI、T2 WI和T2 FLAIR序列。分别对3T和7T MRI不同位置(皮层、近皮层、脑室旁、幕下及非典型位置病灶区域)及直径的病灶进行标记并测量,比较两种场强MRI对病灶不同位置及直径的检出差异。结果共纳入12例诊断明确的多发性硬化患者,平均年龄(32±4.4)岁,男性4例,女性8例。7T MRI共检出多发硬化病灶463个(病灶平均直径:7.2mm),3T MRI共检出多发性硬化病灶319个(病灶平均直径:8.8mm);在皮层、近皮层、脑室旁、幕下及非典型位置病灶区域,7T MRI检出病灶个数分别为14、66、194、28、161;3T MRI检出病灶个数分别为8、41、161、25、84;7T MRI病灶检出率比3T MRI分别提高42.86%、37.88%、17.01%、10.71%、47.83%;在3mm≤直径≤5mm、5mm<直径≤7mm及>7mm直径范围内,7T MRI检出的MS病灶个数分别为:173、121、169;3T MRI检出的MS病灶个数分别为:46、106、167;7T MRI病灶检出率比3T MRI分别提高73.41%、12.40%、1.18%。结论颅脑7T MRI常规序列比指南指导下3T MRI对多发性硬化病灶有更高的检出率,尤其对皮层病灶及3mm≤直径≤5mm范围内的病灶更具检出优势;位置和直径是影响二者对多发性硬化病灶的检出存在差异的主要原因。Objective The value of brain 7T MRI in detecting multiple sclerosis(MS)lesions were compared with 3T MRI recommended by the guidelines.Methods Patients with multiple sclerosis admitted to Beijing Tiantan Hospital Affiliated to Capital Medical University from September 2021 to October2023 were prospectively included,and all the enrolled patients met the 2017 revised diagnostic criteria for McDonald MS.Clinical information was collected,and 3T and 7T brain MRI examinations were performed during hospitalization.The 3T and 7T brain MRI sequences included T1WI,T2WI and T2 FLAIR sequences.The 3T and 7T MRI lesions with different locations(cortical,Juxtacortical,periventricular,Infratentorial and atypical lesions in other areas)and diameters were marked and measured respectively,and the differences in the detection of different locations and diameters of lesions were compared between the two kinds of field intensity MRI.Results A total of12 patients with definite diagnosis of MS were included,with an average age of 32±4.4 years,including 4 males and 8 females.A total of 463 multiple sclerosis lesions(mean lesion diameter:7.2mm)were detected on 7T MRI,and 319 multiple sclerosis lesions(mean lesion diameter:8.8mm)were detected on 3T MRI.The number of lesions detected by 7T MRI were 14,66,194,28 and 161,respectively,in the cortical,Juxtacortical,periventricular,Infratentorial and white matter lesions in other areas.The number of lesions detected by 3T MRI were 8,41,161,25 and 84,respectively.The detection rate of 7T MRI was 42.86%,37.88%,17.01%,10.71% and 47.83% higher than that of 3T MRI,respectively.Within the range of 3mm≤diameter≤5mm,5mm7mm,the number of MS lesions detected by 7T MRI were 173,121 and 169,respectively;The number of MS lesions detected by 3T MRI were 46,106 and 167,respectively.The detection rate of 7T MRI was 73.41%,12.40% and 1.18% higher than that of 3T MRI,respectively.Conclusion The conventional brain 7T MRI sequence has a higher detection rate for multiple sclerosis lesions than the 3T MRI seq

关 键 词：磁共振 超高场强 多发性硬化病灶 7T MRI 

分 类 号：R742.5[医药卫生—神经病学与精神病学]