磁共振评价面神经血管压迫的图像质量控制研究
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摘要
磁共振成像技术在临床中的应用大大提高了疾病的诊断率,促进了医学科学的发展,但磁共振影像的质量控制明显滞后于快速发展的医学影像学技术,为获得高质量的图像,充分满足临床诊断需要的符合质量标准的医学影像,对磁共振所获图像的质量保证与质量控制是极为重要的。
本研究在质量控制理论相关内容的指导下,分析影响磁共振成像系统设备、扫描参数及序列等因素,结合磁共振评价面神经血管压迫的应用实际,分析传统磁共振检查的图像质量不足的原因,提出改善图像质量的改进方案,寻找提高图像质量并达到临床要求的优化方案,得出三维高分辨率MR血管造影与强化三维损毁梯度回波扫描序列图像相结合能够更好显示HFS患者神经血管之间的关系,且具有较高的敏感性和特异性,是临床上面肌痉挛患者行MRI检查首选的扫描.序列,从而,帮助完善了图像质量控制,落实了质量控制目标。
本文分为六部分。
首先,提出获得高质量的图像的问题,把从实际应用中对磁共振所获图像进行质量控制作为其研究目的,进一步提升了磁共振检查的价值,从而实现医学影像学的社会价值。
其次,对质量理念、质量控制运行体系、磁共振评价面神经血管压迫研究所获得图像方法和相关技术因素进行综述。
然后,对影响磁共振成像质量的因素进行分析,通过分析传统磁共振的成像技术因素,从而找到传统检查技术出现质量问题的主要因素,指出改进方向。
接着,对改进磁共振图像质量的实验研究。通过一套独立的临床实验研究,即磁共振评价面肌痉挛患者面神经血管压迫图像质量控制的研究,可获得更为全面、客观地评判面神经与动静脉血管的压迫关系的磁共振图像,满足临床诊断的需要,达到了质量控制的目的。
还有,根据实际应用的情况,发现和分析了图像控制方案的可行性,建设性的提出了神经血管压迫磁共振检查技术规范。
最后,对图像质量控制进行简短总结并提出自己对未来的展望。
The clinical application of magnetic resonance imaging increased the diagnostic rate of disease greatly, and promote the development of medical science, but the qua-lity control of magnetic resonance imaging clearly lags behind the rapid development of medical imaging technology, in order to obtain high-quality images, full to meet clinical needs meet the quality standards of medical imaging, magnetic resonance images obtained of the quality assurance and quality control is extremely important. In this study, the quality control theory under the guidance of relevant content, nalysis on the magnetic resonance imaging equipment, scanning parameters and sequence and other factors, combined with magnetic resonance imaging evaluation of facial nerve and vascular compression of the practical applications, analysis of traditional magnetic resonance imaging because of insufficient image quality, to improve image quality improvement program, looking to improve image quality and meet the clinical requirements of the optimization program, High-resolution 3D MRA in association with contrast-enhanced 3DSPGRI is an extremely sensitive and specific method for demonstrating vascular contact with facial nerve in patients with HFS,Which is the MRI preferred sequences above the muscle spasm of clinical patients.
The thesis is divided into six parts.
Firstly, it is the purpose, meaning and method of the thesis. From a practical application of the magnetic resonance images obtained on quality control as its research purposes, further increasing the value of MRI in order to achieve the social value of medical imaging.
Secondly, the quality concept, quality control operation system, magnetic resonance imaging evaluation of facial nerve and vascular compression institute, image methods and related technical factors were reviewed.
Then, the factors affecting the quality of magnetic resonance imaging analysis of magnetic resonance imaging analysis of the traditional technical factors, the traditional inspection techniques to find the quality problem of the main factors that improve the orientation.
Then, on improving the quality of magnetic resonance images in rats. Clinical trials by an independent study, that MRI evaluation of patients with hemifacial spasm facial nerve and vascular compression of image quality control, access to more comprehensive and objective evaluation of the facial nerve and vein and artery of the oppression of the relationship between magnetic resonance imaging, to meet the clinical diagnostics, to achieve the purpose of quality control.
Also, according to the actual application and found that the image control program and analyzed the feasibility of the proposed constructive Magnetic resonance imaging of neurovascular compression specification.
Finally, a brief summary of the image quality control and to put forward their own vision of the future.
本研究在质量控制理论相关内容的指导下,分析影响磁共振成像系统设备、扫描参数及序列等因素,结合磁共振评价面神经血管压迫的应用实际,分析传统磁共振检查的图像质量不足的原因,提出改善图像质量的改进方案,寻找提高图像质量并达到临床要求的优化方案,得出三维高分辨率MR血管造影与强化三维损毁梯度回波扫描序列图像相结合能够更好显示HFS患者神经血管之间的关系,且具有较高的敏感性和特异性,是临床上面肌痉挛患者行MRI检查首选的扫描.序列,从而,帮助完善了图像质量控制,落实了质量控制目标。
本文分为六部分。
首先,提出获得高质量的图像的问题,把从实际应用中对磁共振所获图像进行质量控制作为其研究目的,进一步提升了磁共振检查的价值,从而实现医学影像学的社会价值。
其次,对质量理念、质量控制运行体系、磁共振评价面神经血管压迫研究所获得图像方法和相关技术因素进行综述。
然后,对影响磁共振成像质量的因素进行分析,通过分析传统磁共振的成像技术因素,从而找到传统检查技术出现质量问题的主要因素,指出改进方向。
接着,对改进磁共振图像质量的实验研究。通过一套独立的临床实验研究,即磁共振评价面肌痉挛患者面神经血管压迫图像质量控制的研究,可获得更为全面、客观地评判面神经与动静脉血管的压迫关系的磁共振图像,满足临床诊断的需要,达到了质量控制的目的。
还有,根据实际应用的情况,发现和分析了图像控制方案的可行性,建设性的提出了神经血管压迫磁共振检查技术规范。
最后,对图像质量控制进行简短总结并提出自己对未来的展望。
The clinical application of magnetic resonance imaging increased the diagnostic rate of disease greatly, and promote the development of medical science, but the qua-lity control of magnetic resonance imaging clearly lags behind the rapid development of medical imaging technology, in order to obtain high-quality images, full to meet clinical needs meet the quality standards of medical imaging, magnetic resonance images obtained of the quality assurance and quality control is extremely important. In this study, the quality control theory under the guidance of relevant content, nalysis on the magnetic resonance imaging equipment, scanning parameters and sequence and other factors, combined with magnetic resonance imaging evaluation of facial nerve and vascular compression of the practical applications, analysis of traditional magnetic resonance imaging because of insufficient image quality, to improve image quality improvement program, looking to improve image quality and meet the clinical requirements of the optimization program, High-resolution 3D MRA in association with contrast-enhanced 3DSPGRI is an extremely sensitive and specific method for demonstrating vascular contact with facial nerve in patients with HFS,Which is the MRI preferred sequences above the muscle spasm of clinical patients.
The thesis is divided into six parts.
Firstly, it is the purpose, meaning and method of the thesis. From a practical application of the magnetic resonance images obtained on quality control as its research purposes, further increasing the value of MRI in order to achieve the social value of medical imaging.
Secondly, the quality concept, quality control operation system, magnetic resonance imaging evaluation of facial nerve and vascular compression institute, image methods and related technical factors were reviewed.
Then, the factors affecting the quality of magnetic resonance imaging analysis of magnetic resonance imaging analysis of the traditional technical factors, the traditional inspection techniques to find the quality problem of the main factors that improve the orientation.
Then, on improving the quality of magnetic resonance images in rats. Clinical trials by an independent study, that MRI evaluation of patients with hemifacial spasm facial nerve and vascular compression of image quality control, access to more comprehensive and objective evaluation of the facial nerve and vein and artery of the oppression of the relationship between magnetic resonance imaging, to meet the clinical diagnostics, to achieve the purpose of quality control.
Also, according to the actual application and found that the image control program and analyzed the feasibility of the proposed constructive Magnetic resonance imaging of neurovascular compression specification.
Finally, a brief summary of the image quality control and to put forward their own vision of the future.
引文
[1]中华人民共和国卫生行业标准.医用磁共振成像设备影像质量检测与评价规范[S].中华人民共和国卫生部,2006,1-12.
[2]吴承运,刘玉光.三叉神经痛[M].济南：山东科学技术出版,2004,102-103.
[3]李铁铮.面肌痉挛综述[J].神经疾病与精神卫生,2005,5(5)：36-37.
[4]Nielson VK.Eletrophysiology of hamifacial spasm,in May M(ed):The facial nerve [J] New York,Thieme,1986,487-497.
[5]黎庆翔主编.IS09001：2000标准理解与认证实务[M].广东：广东经济出版社,2003.
[6]赵喜平.磁共振成像系统的原理及其应用[M].北京：科学出版社.469-538,556-572.
[7]Gardner WJ,Sava GA.Heraifacial spasm:A reversible Path physiologic state[J].J Neurosurg,1962,19:240-247.
[8]Jannetta PJ,Abbasy M,Maroon JC,et a 1.Aetiology and definite micro surgical treatment of hemifacial spasm[J].Neurosurg.1977,47:321-328.
[9]袁越,王岩,张思迅,等.显微血管减压术治疗面肌痉挛的临床研究[J].立体定向和功能性神经外科.2004,17(1)：204-206.
[10]张继志,段云平,高宝山,等.“桥延沟”在面神经微血管减压术中的重要意义.[J].中华神经医学杂志,2006,5(9)：931-933.
[11]施增儒,王中秋,吴树春,主编.五官CT和MRI诊断学[M].南京：南京大学出版社,1997,131.
[12]Digre KB,Corbett JJ,Smoker WR,et al.CT and hemifacial spasm [J]. Neurology,1988.38:1111-1113.
[13]汪建华,卢仁根,胡碧波.多层螺旋CT面神经管曲面重建图像的解剖与临床应用[J].临床放射学杂志,2003,22(11)：919-923.
[14]段菊如,林敏,熊俊平,等.面神经颞骨内段在横断薄层和CT上的定位及临床意义[J].中国临床解剖学杂志,2004,22(3)：257-260.
[15]陈青华,柳澄,刘凯,等.多层CT面神经管MPR双斜位成像方法[J].医学影像学杂志,2006,16(6)：541-544.
[16]Bowen YW,Steinberg GK,Rosen L,et al.Magnetic resonance imaging of vascular compression in trigeminal neuralgia case report[J]. J Neurosurg,989.70:132-134.
[17]KurnonY,SakakiS,KohnoK,et al.Three-dimensional imaging for presentation of the causative vessels in patients with hemifacial spasm and trigeminal neuralgia[J]. SurgNeurol,1997,47(2):178-184.
[18]Tarnaris A, Renowden S, Coakham HB. A comparison of magnetic re- sonance angiography and constructive interference in steady state three-dimensional Fourier transformation magnetic resonance imag-ing in patients with hemifacial spasm[J]. J Neurosurg.2007,21 (4):375-381.
[19]雷晓环,卢范,韩文江,等.面神经、位听神经在脑桥小脑角和内耳道与动脉的关系及其血供[J].解剖学杂志.1987,10(3)：222-226.
[20]赵卫国,胡锦清,准春华,等.磁共振3D-SPGR序列成像技术在面肌痉挛术前评估中的作用[J].中华神经外科杂志,2002,5(18)：3192-194.
[21]Nagaseki Y,Horikoshi T,Omata T,et al.Oblique saggittal magnetic resonance imaging visualizing vascular compression of the trige- minal or facial nerve[J]. J Neurosurg.1992,77:379-386.
[22]Meaney JF,Eldfidge PR,Dunn LT.Demonstration of neurovascular com- pression in trigeminal neuralgia with magnetic resonance imaging Comparison with surgical findings in 52 consecutive operative cases [J]. J Neurosurg,1995,83:799-805.
[23]Tarnaris A,Renowden S,Coakham HB.A comparison of magnetic resonance angiography and constructive interference in steady state three -dimensional Fourier transformation magnetic resonance imaging in patients with hemifacial spasm [J]. Br J Neurosurg,2007,21:375-381.
[24]Satoh T,Onoda K,Dat,etal.Preoperative simulation for microvascular decompression in patients with idiopathic trigeninal neuralgia:visualization wih 3D MR cisternogram/angiogram fusion imaging[J]. Neurosurgery,2007,60 (1):1042114.
[25]张伟国,张绍祥,巫北海,等.Ⅵ-Ⅷ对脑神经生物塑化薄片断层解剖与MRI对照研究[J].中国临床解剖学杂志,2002.20(4)：279-282.
[26]孙文阁,李延亮.三维时间飞跃扰相梯度回波采集序列和三维快速高级自旋回波对颅神经与邻近血管关系的对比研究[J].中华放射学杂志,2004,38(12)：1248-1251.
[27]马芳芳,李明,谭永星.内耳内听道及面神经的磁共振成像研究[J].泰山医学院学报,2005,26(4)：301-303.
[28]林青,童绥君,曲红丽等.磁共振断层血管成像对面肌痉挛病因的诊断价值[J].疑难病杂志,2008,7(4)：218-220.
[29]郑兆聪,陈自谦,王如密.磁共振断层血管成像在三叉神经痛及面肌痉挛术前评估中的应用价值[J].福州总医院学报,2009,16(1)：18-20.
[30]戴建平,祁吉.放射学科技术部门的管理放射技术部门的质量管理[M].医院管理学医学影像管理分册,第1版,北京：人民卫生出版社,2003：77-81.
[31]Och JG,Clarke GD,Sobol WT,et al.Acceptance testing of magnetic resonance imaging systems[R]. Report of AAPM Nuclear Magnetic Resonance Task Group,No,6,Med Phys,1992,19:217-229.
[32]彭振军.医用磁共振成像技术[M].武汉：湖北科学技术出版社,1998：130-137,209,
[33]Jeffrey C,Weinreb,RA,Bell GD,et al.Resonance imaging quality control manual[M].2004.
[34]邹文,金德勤,高利臣.磁共振图像质量控制及参数的优化选择[J].中国医疗设备,2008,23(3)：51-53.
[35]李伟,郭云峰,罗学毛,等.MR成像中脉冲序列特征与图像质量控制[J].实用医技杂志,2004(1)：8-12.
[36]徐子森,唐立民,王燕.影响MR成像质量的因素分析[J].医疗设备信息,2003(9)：31-33.
[2]吴承运,刘玉光.三叉神经痛[M].济南：山东科学技术出版,2004,102-103.
[3]李铁铮.面肌痉挛综述[J].神经疾病与精神卫生,2005,5(5)：36-37.
[4]Nielson VK.Eletrophysiology of hamifacial spasm,in May M(ed):The facial nerve [J] New York,Thieme,1986,487-497.
[5]黎庆翔主编.IS09001：2000标准理解与认证实务[M].广东：广东经济出版社,2003.
[6]赵喜平.磁共振成像系统的原理及其应用[M].北京：科学出版社.469-538,556-572.
[7]Gardner WJ,Sava GA.Heraifacial spasm:A reversible Path physiologic state[J].J Neurosurg,1962,19:240-247.
[8]Jannetta PJ,Abbasy M,Maroon JC,et a 1.Aetiology and definite micro surgical treatment of hemifacial spasm[J].Neurosurg.1977,47:321-328.
[9]袁越,王岩,张思迅,等.显微血管减压术治疗面肌痉挛的临床研究[J].立体定向和功能性神经外科.2004,17(1)：204-206.
[10]张继志,段云平,高宝山,等.“桥延沟”在面神经微血管减压术中的重要意义.[J].中华神经医学杂志,2006,5(9)：931-933.
[11]施增儒,王中秋,吴树春,主编.五官CT和MRI诊断学[M].南京：南京大学出版社,1997,131.
[12]Digre KB,Corbett JJ,Smoker WR,et al.CT and hemifacial spasm [J]. Neurology,1988.38:1111-1113.
[13]汪建华,卢仁根,胡碧波.多层螺旋CT面神经管曲面重建图像的解剖与临床应用[J].临床放射学杂志,2003,22(11)：919-923.
[14]段菊如,林敏,熊俊平,等.面神经颞骨内段在横断薄层和CT上的定位及临床意义[J].中国临床解剖学杂志,2004,22(3)：257-260.
[15]陈青华,柳澄,刘凯,等.多层CT面神经管MPR双斜位成像方法[J].医学影像学杂志,2006,16(6)：541-544.
[16]Bowen YW,Steinberg GK,Rosen L,et al.Magnetic resonance imaging of vascular compression in trigeminal neuralgia case report[J]. J Neurosurg,989.70:132-134.
[17]KurnonY,SakakiS,KohnoK,et al.Three-dimensional imaging for presentation of the causative vessels in patients with hemifacial spasm and trigeminal neuralgia[J]. SurgNeurol,1997,47(2):178-184.
[18]Tarnaris A, Renowden S, Coakham HB. A comparison of magnetic re- sonance angiography and constructive interference in steady state three-dimensional Fourier transformation magnetic resonance imag-ing in patients with hemifacial spasm[J]. J Neurosurg.2007,21 (4):375-381.
[19]雷晓环,卢范,韩文江,等.面神经、位听神经在脑桥小脑角和内耳道与动脉的关系及其血供[J].解剖学杂志.1987,10(3)：222-226.
[20]赵卫国,胡锦清,准春华,等.磁共振3D-SPGR序列成像技术在面肌痉挛术前评估中的作用[J].中华神经外科杂志,2002,5(18)：3192-194.
[21]Nagaseki Y,Horikoshi T,Omata T,et al.Oblique saggittal magnetic resonance imaging visualizing vascular compression of the trige- minal or facial nerve[J]. J Neurosurg.1992,77:379-386.
[22]Meaney JF,Eldfidge PR,Dunn LT.Demonstration of neurovascular com- pression in trigeminal neuralgia with magnetic resonance imaging Comparison with surgical findings in 52 consecutive operative cases [J]. J Neurosurg,1995,83:799-805.
[23]Tarnaris A,Renowden S,Coakham HB.A comparison of magnetic resonance angiography and constructive interference in steady state three -dimensional Fourier transformation magnetic resonance imaging in patients with hemifacial spasm [J]. Br J Neurosurg,2007,21:375-381.
[24]Satoh T,Onoda K,Dat,etal.Preoperative simulation for microvascular decompression in patients with idiopathic trigeninal neuralgia:visualization wih 3D MR cisternogram/angiogram fusion imaging[J]. Neurosurgery,2007,60 (1):1042114.
[25]张伟国,张绍祥,巫北海,等.Ⅵ-Ⅷ对脑神经生物塑化薄片断层解剖与MRI对照研究[J].中国临床解剖学杂志,2002.20(4)：279-282.
[26]孙文阁,李延亮.三维时间飞跃扰相梯度回波采集序列和三维快速高级自旋回波对颅神经与邻近血管关系的对比研究[J].中华放射学杂志,2004,38(12)：1248-1251.
[27]马芳芳,李明,谭永星.内耳内听道及面神经的磁共振成像研究[J].泰山医学院学报,2005,26(4)：301-303.
[28]林青,童绥君,曲红丽等.磁共振断层血管成像对面肌痉挛病因的诊断价值[J].疑难病杂志,2008,7(4)：218-220.
[29]郑兆聪,陈自谦,王如密.磁共振断层血管成像在三叉神经痛及面肌痉挛术前评估中的应用价值[J].福州总医院学报,2009,16(1)：18-20.
[30]戴建平,祁吉.放射学科技术部门的管理放射技术部门的质量管理[M].医院管理学医学影像管理分册,第1版,北京：人民卫生出版社,2003：77-81.
[31]Och JG,Clarke GD,Sobol WT,et al.Acceptance testing of magnetic resonance imaging systems[R]. Report of AAPM Nuclear Magnetic Resonance Task Group,No,6,Med Phys,1992,19:217-229.
[32]彭振军.医用磁共振成像技术[M].武汉：湖北科学技术出版社,1998：130-137,209,
[33]Jeffrey C,Weinreb,RA,Bell GD,et al.Resonance imaging quality control manual[M].2004.
[34]邹文,金德勤,高利臣.磁共振图像质量控制及参数的优化选择[J].中国医疗设备,2008,23(3)：51-53.
[35]李伟,郭云峰,罗学毛,等.MR成像中脉冲序列特征与图像质量控制[J].实用医技杂志,2004(1)：8-12.
[36]徐子森,唐立民,王燕.影响MR成像质量的因素分析[J].医疗设备信息,2003(9)：31-33.