MR3D-DIR序列联合1H-MRS对多发性硬化患者脑内病变的检测价值分析  

Analysis of the value of MR3D-DIR sequence combined with 1H-MRS in detecting intracerebral lesions in multiple sclerosis patients

作　　者：熊付伟 李璐 龚博 XIONG Fuwei;LI Lu;GONG Bo(Department of Imaging,the Second People's Hospital of Henan Province,Xinzheng 451100,China;Department of Imaging,Luoyang Yiluo Hospital,Luoyang 471000,China)

机构地区：[1]河南省第二人民医院影像科,河南新郑451100 [2]洛阳伊洛医院影像科,河南洛阳471000

出　　处：《黑龙江医药科学》2024年第4期53-56,共4页Heilongjiang Medicine and Pharmacy

基　　金：河南省医学科技攻关联合共建项目,编号:LHGJ20221030。

摘　　要：目的:探讨磁共振三维翻转恢复序列(MR3D-DIR)联合氢质子磁共振波谱(1H-MRS)对多发性硬化(MS)患者脑内病变的诊断价值。方法:回顾性选取2020年7月至2023年11月河南省第二人民医院收治的疑似MS患者46例,均行MR3D-DIR、1H-MRS检查,并以临床最终结果为“金标准”,将患者分别纳入MS组31例及非MS组15例。比较两组1H-MRS参数、MR3D-DIR结果、1H-MRS结果及临床结果,比较MR3D-DIR、1H-MRS及联合诊断效能,比较不同序列对不同部位颅内病灶数的检出率。结果:MS组NAA/(Cr+Cho)值<非MS组,Lac/Cr、Cho/Cr>非MS组(P<0.05);MR3D-DIR诊断灵敏度为70.97%(22/31)、特异度为86.67%(13/15)、准确度为76.09%(35/46),1H-MRS诊断灵敏度为67.74%(21/31)、特异度为93.33%(14/15)、准确度为76.09%(35/46),联合诊断灵敏度为93.55%(29/31)、特异度为86.67%(13/15)、准确度为91.30%(42/46);联合诊断灵敏度高于MR3D-DIR、1H-MRS单独诊断,漏诊率低于二者单独诊断,且联合诊断对皮质内病灶、近皮质病灶检出率及总检出率均高于二者单独诊断(P<0.05)。结论:MR3D-DIR联合多体素1H-MRS可提高MRI诊断灵敏度,对MS患者脑内病变具有较高诊断价值,可作为临床诊断MS的有效方案之一。Objective:To investigate the diagnostic value of three-dimensional magnetic resonance inversion recovery sequence(MR3D-DIR)combined with hydrogen proton magnetic resonance spectroscopy(1H-MRS)in patients with multiple sclerosis(MS).Methods:A total of 46 patients with suspected MS admitted to Henan Second People's hospital from July 2020 to November 2023 were retrospectively selected,and all of them underwent MR3D-DIR and 1H-MRS examinations,and were included in the MS group(31 cases)and the non-MS group(15 cases),using the final clinical results as the“gold standard”.The patients were included in the MS group(31 cases)and the non-MS group(15 cases).The parameters of 1H-MRS in the two groups were compared,the results of MR3D-DIR,1H-MRS and clinical results were compared,the diagnostic efficacy of MR3D-DIR,1H-MRS and combined diagnosis was compared,and the detection rate of different sequences for the number of intracranial lesions in different locations was compared.Results:NAA/(Cr+Cho)value in MS group was lower than that in non-MS group,Lac/Cr and Cho/Cr were higher than that in non-MS group(P<0.05).The diagnostic sensitivity of MR3D-DIR was 70.97%(22/31),the specificity was 86.67%(13/15)and the accuracy was 76.09%(35/46).The diagnostic sensitivity,specificity and accuracy of 1H-MRS were 67.74%(21/31),93.33%(14/15)and 76.09%(35/46),and the combined diagnostic sensitivity was 93.55%(29/31),specificity was 86.67%(13/15)and accuracy was 91.30%(42/46).The sensitivity of combined diagnosis was higher than that of MR3D-DIR and 1H-MRS alone,and the rate of missed diagnosis was lower than that of MR3D-DIR and 1H-MRS alone,and the detection rate and total detection rate of combined diagnosis were higher than those of MR3D-DIR and 1H-MRS alone(P<0.05).Conclusion:MR3D-DIR combined with multi-voxel 1H-MRS can improve the diagnostic sensitivity of MRI,and has high diagnostic value for intracerebral lesions in MS patients,and can be used as one of the effective schemes for clinical diagnosis of MS.

关 键 词：磁共振三维翻转恢复序列 氢质子磁共振波谱 多发性硬化 脑内病变 

分 类 号：R744.51[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]