钆对比剂剂量对增强T2 FLAIR序列与增强T1WI序列脑转移瘤强化效果的影响及对比研究  

Comparative study of different doses of gadolinium contrast agent on contrast enhanced T2 FLAIR and T1WI in diagnosis of brain metastases

作　　者：曹明慧 苏赟[1] 苏卫锋 毛家骥[1] 李韵华 沈君[1] CAO Minghui;SU Yun;SU Weifeng;MAO Jiaji;LI Yunhua;SHEN Jun(Department of Radiology,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院放射科,广东省恶性肿瘤表观遗传与基因调控重点实验室,广州510120

出　　处：《磁共振成像》2024年第1期152-157,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金项目(编号:12126610)。

摘　　要：目的 对比不同剂量钆对比剂注射后增强液体衰减反转恢复(contrast enhanced T2 fluid attenuated inversion recovery,CE-T2 FLAIR)序列与对比增强T1WI(contrast enhanced T1WI, CE-T1WI)上脑转移瘤的强化效果,探讨半剂量对比剂条件下CE-T2 FLAIR序列在脑转移瘤MRI检查的诊断价值。材料与方法 前瞻性纳入颅外原发恶性肿瘤经病理学明确诊断、脑转移瘤经病理或临床随访证实的患者30例,于3.0 T MRI设备行头颅MRI增强扫描,在常规平扫序列的基础上,行半剂量(0.05 mmol/kg)CE-T2 FLAIR和CE-T1WI扫描,随后分次补充钆对比剂达常规剂量(0.1 mmol/kg)后至双倍剂量(0.2 mmol/kg),在注射对比剂后均进行CE-T2 FLAIR和CE-T1WI扫描。由两位观察者对三次扫描的CE-T2 FLAIR和CE-T1WI图像进行客观测量。计算不同剂量条件下CE-T2 FLAIR和CE-T1WI图像的对比信噪比(contrast to noise ratio, CNR)、相对对比度(relative contrast, RC)及百分比增加(percentage increase, PI)。采用方差分析对客观测量结果进行组间比较,差异有统计学意义(P<0.05)时进行后续多重比较;采用t检验比较两组之间的差异。结果 两位观察者客观评分一致性良好。三组对比剂剂量下CE-T2 FLAIR图像间CNR值与RC值差异无统计学意义(P>0.05);与平扫T2 FLAIR相比,病灶PI增高,增强效果良好。三组对比剂剂量下CE-T1WI图像间CNR值与RC值差异有统计学意义(P<0.05),两两比较结果表明双倍剂量CE-T1WI图像上CNR值及RC值均明显大于半剂量组(P<0.05)。半剂量及常规剂量CE-T2 FLAIR图像CNR值及RC值上均较该组CE-T1WI明显增大,差异有统计学意义(P<0.05)。半剂量CE-T2 FLAIR图像CNR值及RC值均明显大于常规剂量CE-T1WI(P<0.05)。与双倍剂量CE-T1WI相比,半剂量CE-T2 FLAIR图像CNR值增大(P<0.05),RC值差异无统计学意义(P>0.05)。结论 半剂量对比剂下CE-T2FLAIR图像上脑转移瘤的强化效果与常规CE-T1WI相仿,病灶显示良好,为半剂量对比剂的CE-T2 FObjective:To determine the efficacy of contrast enhanced T2 fluid attenuated inversion recovery(CE-T2 FLAIR)sequence and contrast enhanced T1 weighted imaging(CE-T1WI)of brain metastases after injection of different doses of gadolinium contrast agent,and to investigate the clinical value of half-dose contrast agent enhanced T2 FLAIR sequence in the diagnosis of brain metastases.Materials and Methods:A total of 30 patients with a history of extracranial primary malignant tumors confirmed by pathological diagnosis and brain metastases confirmed by pathological or clinical follow-up were prospectively enrolled.On the basis of conventional non-enhanced T1WI and T2 FLAIR sequences using a 3.0 T MRI equipment,CE-T2 FLAIR and CE-T1WI scans were performed after administration of half-dose(0.05 mmol/kg)gadolinium-based contrast agent(GBCA),followed by fractional supplementation of GBCA to the conventional-dose(0.1 mmol/kg)and double-dose(0.2 mmol/kg).After injection of the GBCA,both CE-T2 FLAIR and CE-T1WI scans were performed.Objective measurements of images were performed by two observers.The contrast-to-noise ratio(CNR),relative-contrast(RC),and percentage increase(PI)of CE-T2 FLAIR and CE-T1WI images under different doses were calculated.Analysis of variance were used to analyze objective measurements between different groups and multiple comparisons were performed when the difference was statistically significant(P<0.05).The t-test was used to analyze the differences between two groups.Results:The objective scores were consistent between two observers.There was no significant difference in CNR and RC values among CE-T2 FLAIR images under three different doses of GBCA(P>0.05).Compared with non-enhanced T2 FLAIR scanning,the PI of the lesion was increased.There were significant differences in the CNR and RC values between the CE-T1WI images at three different doses of GBCA(P<0.05).The results of pairwise comparison showed that the CNR and RC values on the doubling-dose CE-T1WI images were significantly higher than thos

关 键 词：脑转移瘤 磁共振成像 液体衰减反转恢复序列 半剂量钆对比剂 对比增强 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]