两种三维磁共振神经成像技术对鼻咽癌患者下颌神经颅外段显示效果的对比研究  

Comparative study on the display effect of two three-dimensional magnetic resonance neuroimaging techniques on mandibular nerve extracranial segment in patients with nasopharyngeal carcinoma

作　　者：罗江静 徐列印[1] 胡玉芳[1] 唐艳云[1] LUO Jiangjing;XU Lieyin;HU Yufang;TANG Yanyun(Department of Radiology,the Affiliated Hospital of Guilin Medical College,Guiliu 541001,China)

机构地区：[1]桂林医学院附属医院放射科,桂林541001

出　　处：《磁共振成像》2025年第3期38-43,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：桂林市科技计划项目(编号:20230135-3-3);桂林医学院中青年教职工科研能力提升项目(编号:2018glmcy065);广西壮族自治区卫生健康委员会自筹经费科研课题项目(编号:Z20190755)。

摘　　要：目的 比较磁共振三维双回波稳态进动(three-dimensional double echo steady state,3D-DESS)序列与三维短时反转恢复快速自旋回波成像(three-dimensional flip-angle evolution short-tau inversion,3D-SPACE-STIR)序列对鼻咽癌患者下颌神经颅外段显示的可行性与两者的临床应用价值。材料与方法 回顾性分析符合纳入及排除标准36例鼻咽癌患者(共计72支下颌神经)的图像资料。采用配对样本t检验及配对样本Wilcoxon符号秩和检验比较两序列图像显示质量的主观评分和客观参数指标[包括图像的信号强度比(signal intensity ratio,SIR)、信噪比(signal-to-noise ratio,SNR)、对比噪声比(contrast-to-noise ratio,CNR)];采用配对卡方检验比较两序列对鼻咽癌累及下颌神经显示情况。结果 3D-DESS及3D-SPACE-STIR序列对下颌神经均有较高的显示率,两者图像主观质量评分均表现良好,分别为4分和3分,差异无统计学意义(P=0.052);3D-SPACE-STIR序列SIR_(N/M)优于3D-DESS序列,分别为3.55和1.40,差异具有统计学意义(P<0.001);3D-DESS序列SNR_(M)优于3D-SPACE-STIR序列,分别为13.68和8.00,差异具有统计学意义(P=0.002)。24支下颌神经被肿瘤累及,3D-DESS序列显示神经与肿瘤的关系(95.83%vs.12.50%)、神经的连续性(87.50%vs.37.50%)、肿瘤段神经的形态(70.83%vs.29.17%)优于3D-SPACE-STIR序列,差异具有统计学意义(P<0.001,P<0.001,P=0.004);3D-SPACE-STIR序列显示非肿瘤段神经增粗优于3D-DESS序列(70.83%vs.41.67%),差异具有统计学意义(P=0.042)。结论 3D-DESS与3D-SPACE-STIR对下颌神经颅外段具有相似的显示率,但是3D-DESS基于较好的神经与周围结构关系分辨率,低视野值,其临床应用值得推广。Objective:To compare the feasibility and value of three-dimensional double echo steady state(3D-DESS) sequence and three-dimensional flip-angle evolution short-tau inversion(3D-SPACE-STIR) sequence in the display of mandibular nerve extracranial segment in patients with nasopharyngeal carcinoma.Materials and Methods:The image data of 36 patients with nasopharyngeal carcinoma meeting the inclusion and exclusion criteria were retrospectively analyzed,with a total of 72 mandibular nerves.The paired sample t test and paired sample Wilcoxon sign rank sum test were used to compare the subjective scores and objective parameters of the display quality of the two sequences,including the signal intensity ratio(SIR),signal-to-noise ratio(SNR) and contrast-to-noise ratio(CNR) of the images.Paired Chi-square test was used to compare the mandibular nerve involvement between the two sequences in nasopharyngeal carcinoma.Results:Both 3D-DESS and 3D-SPACE-STIR sequences had a higher display rate of mandibular nerve,and the subjective quality scores of both showed a good performance,which were 4 and 3 points,respectively,with no statistical significance(P = 0.052);3D-SPACE-STIR sequence SIR_(N/M) was better than 3D-DESS sequence,3.55 and 1.40,respectively,and the difference was statistically significant(P < 0.001).SNR_(M) of 3D-DESS sequence was better than that of 3D-SPACE-STIR sequence(13.68 and 8.00,respectively),and the difference was statistically significant(P = 0.002).A total of 24 mandibular nerves were involved by tumors.3D-DESS sequences showed better relationship between nerves and tumors(95.83% vs.12.50%),nerve continuity(87.50% vs.37.50%)and nerve morphology(70.83% vs.29.17%) of tumor segments than 3D-SPACE-STIR sequences,and the differences were statistically significant(P < 0.001,P < 0.001,P = 0.004).The 3D-SPACE-STIR sequence showed that the nerve thickening in non-tumor segment was better than that in 3D-DESS sequence(70.83% vs.41.67%),and the difference was statistically significant(P = 0.042).Conclusions:3D-DESS

关 键 词：三维双回波稳态进动序列 三维短时反转恢复快速自旋回波成像序列 下颌神经 磁共振成像 鼻咽癌 脑神经 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.62[医药卫生—诊断学]