磁共振3D-T1WI序列在新生儿局灶性脑白质损伤病灶检出中的应用
|
摘要
目的比较磁共振三维T1加权成像(three-dimensional T1 weighted imaging,3D-T1WI)序列与常规T1加权成像(T1weightedimaging,T1WI)、T2加权成像(T2 weighted imaging,T2WI)及磁共振成像新技术(磁共振扩散成像及磁敏感加权成像)在新生儿局灶性脑白质损伤(punctate white matter lesions,PWML)病灶检出中的差异,评价3D-T1WI序列在新生儿颅脑磁共振检查中的价值。材料与方法研究对象为2011年3月至2013年2月在我院GE 3.0 T磁共振设备行颅脑MRI检查诊断为PWML的新生儿。扫描序列包括3D-T1WI(FSPGR序列)、T2WI、扩散张量成像(diffusion tensor imaging,DTI)及磁敏感加权成像(3D-enhanced susceptibility-weighted angiography,ESWAN)。分别观察3D-T1WI、重建T1WI(3D-T1WI重建的4mm图像)、常规T2WI、DTI后处理的表观扩散系数(apparent diffusion coefficient,ADC)图及ESWAN后处理的幅度(Magnitude)图,比较各序列图像对PWML病例数及病灶数检出的差异。结果 (1) 84例PWML病例,3D-T1WI、重建T1WI、常规T2WI、ADC图和Magnitude图检出PWML病例数分别为84(100%)、69(82.14%)、71(84.52%)、73(86.90%)和70(83.33%)。(2)3D-T1WI、重建T1WI、常规T2WI、ADC图和Magnitude图对可计数之53例PWML病例检出的病灶总数分别为422、151、185、142和152。3D-T1WI与其他各序列检出PWML病灶数两两比较有明显统计学差异(P<0.001)。与3D-T1WI比较,重建T1WI、常规T2WI、ADC图及Magnitude图对53例PWML病灶的检出率分别为35.78%(151/422)、43.84%(185/422)、33.65%(142/422)、36.02%(152/422)。结论 3D-T1WI序列对PWML病例及病灶的检出率均高于常规T1WI、T2WI及磁共振新技术(ADC图、Magnitude图),可作为新生儿颅脑MR检查的常规序列。
Objective: To compare the different for detecting neonatal punctate white matter lesions between three-dimensional T1 weighted imaging(3 D-T1 WI) and conventional MRI, diffusion imaging and susceptibility-weighted imaging, and to assess the value of 3 D-T1 WI sequence in the brain MR examination for neonates. Materials and Methods: Between March 2011 and February 2013, neonates with PWML underwent 3.0 T MRI exam were recruited. The routine protocol included 3 D-T1 WI, T2 weighted imaging(T2 WI), diffusion tensor imaging(DTI) and 3 D-enhanced susceptibility-weighted angiography(ESWAN). Reformatted T1 WI(4 mm), apparent diffusion coefficient(ADC) map and magnitude image were obtained from 3 D-T1 WI, DTI and ESWAN, respectively. The numbers of PWML cases and lesions were calculated in all images independently. Results:(1) The number of cases that identified by 3 D-T1 WI, reformatted T1 WI, T2 WI, ADC maps and magnitude maps were 84(100%), 69(82.14%), 71(84.52%), 73(86.90%) and 70(83.33%), respectively.(2) For 53 cases whose lesions can be counted, the total number of lesions detected by 3 D-T1 WI, reformatted T1 WI, T2 WI, ADC maps and magnitude maps were 422, 151, 185, 142 and 152, respectively. There are significant difference of the detectivity of punctate lesions between 3 D T1 WI and other MRI sequences(P<0.001). Comparing to 3 D-T1 WI, the detection rate of reformatted T1 WI, T2 WI, ADC maps and magnitude maps was 35.78%(151/422)、43.84%(185/422)、33.65%(142/422)、36.02%(152/422), respectively. Conclusions: The detection rate of punctate lesions in 3 D T1 WI is higher than that in other MRI sequences. It is greatly recommended to use 3 D T1 WI as a routine sequence for neonatal brain MR examination.
Objective: To compare the different for detecting neonatal punctate white matter lesions between three-dimensional T1 weighted imaging(3 D-T1 WI) and conventional MRI, diffusion imaging and susceptibility-weighted imaging, and to assess the value of 3 D-T1 WI sequence in the brain MR examination for neonates. Materials and Methods: Between March 2011 and February 2013, neonates with PWML underwent 3.0 T MRI exam were recruited. The routine protocol included 3 D-T1 WI, T2 weighted imaging(T2 WI), diffusion tensor imaging(DTI) and 3 D-enhanced susceptibility-weighted angiography(ESWAN). Reformatted T1 WI(4 mm), apparent diffusion coefficient(ADC) map and magnitude image were obtained from 3 D-T1 WI, DTI and ESWAN, respectively. The numbers of PWML cases and lesions were calculated in all images independently. Results:(1) The number of cases that identified by 3 D-T1 WI, reformatted T1 WI, T2 WI, ADC maps and magnitude maps were 84(100%), 69(82.14%), 71(84.52%), 73(86.90%) and 70(83.33%), respectively.(2) For 53 cases whose lesions can be counted, the total number of lesions detected by 3 D-T1 WI, reformatted T1 WI, T2 WI, ADC maps and magnitude maps were 422, 151, 185, 142 and 152, respectively. There are significant difference of the detectivity of punctate lesions between 3 D T1 WI and other MRI sequences(P<0.001). Comparing to 3 D-T1 WI, the detection rate of reformatted T1 WI, T2 WI, ADC maps and magnitude maps was 35.78%(151/422)、43.84%(185/422)、33.65%(142/422)、36.02%(152/422), respectively. Conclusions: The detection rate of punctate lesions in 3 D T1 WI is higher than that in other MRI sequences. It is greatly recommended to use 3 D T1 WI as a routine sequence for neonatal brain MR examination.
引文
[1]Wagenaar N,Chau V,Groenendaal F,et al.Clinical risk factors for punctate white matter lesions on early magnetic resonance imaging in preterm newborns.J Pediatr,2017,182(3):34-40.
[2]Kersbergen KJ,Benders MJ,Groenendaal F,et al.Different patterns of punctate white matter lesions in serially scanned preterm infants.Plos One,2014,9(10):e108904.
[3]de Bruine FT,van den Berg-Huysmans AA,Leijser LM,et al.Clinical implications of MR imaging findings in the white matter in very preterm infants:a 2-year follow-up study.Radiology,2011,261(3):899-906.
[4]Gao J,Zhang YM,SUN QL,et al.White matter variations in preterm and full term neonates with punctate white matter lesions:a diffusion tensor study based on tract-based spatial statistics.Chin J Magn Reson Imaging,2014,5(1):24-29.高洁,张育苗,孙亲利,等.基于纤维束空间统计分析法研究早产及足月新生儿局灶性脑白质损伤的扩散张量成像特点.磁共振成像,2014,5(1):24-29.
[5]Childs AM,Cornette L,Ramenghi LA,et al.Magnetic resonance and cranial ultrasound characteristics of periventricular white matter abnormalities in newborn infants.Clin Radiol,2001,56(8):647-655.
[6]Cornette L,Tanner S,Ramenghi L,et al.Magnetic resonance imaging of the infant brain:anatomical characteristics and clinical significance of punctate lesions.Arch Dis Child Fetal Neonatal Ed,2002,86(3):171-177.
[7]Tortora D,Panara V,Mattei PA,et al.Comparing 3T T1-weighted sequences in identifying hyperintense punctate lesions in preterm neonates.AJNR Am J Neuroradiol,2015,36(3):581-586.
[8]Nanba Y,Matsui K,Aida N,et al.Magnetic resonance imaging regional T1 abnormalities at term accurately predict motor outcome in preterm infants.Pediatrics,2007,120(1):e10-19.
[9]Cote CJ,Wilson S.Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures:an update.Pediatrics,2006,118(6):2587-2602.
[10]Rutherford MA,Supramaniam V,Ederies A,et al.Magnetic resonance imaging of white matter diseases of prematurity Neuroradiology,2010,52(6):505-521.
[11]Niwa T,de Vries LS,Benders MJ,et al.Punctate white matter lesions in infants:new insights using susceptibility-weighted imaging.Neuroradiology,2011,53(9):669-679.
[12]Nossin-Manor R,Chung AD,Morris D,et al.Optimized T1-and T2-weighted volumetric brain imaging as a diagnostic tool in very preterm neonates.Pediatric Radiology,2011,41(6):702.
[13]Wintersperger BJ,Runge VM,Biswas J,et al.Brain tumor enhancement in MR imaging at 3 Tesla:comparison of SNR and CNR gain using TSE and GRE techniques.Invest Radiol,2007,42(8):558-563.
[14]Edelman RR,Dunkle EI.Rapid whole-brain magnetic resonance imaging with isotropic resolution at 3 Tesla.Invest Radiol,2009,44(1):54-59.
[15]Qi Y,Wang XM.Early Diagnostic and Prognostic Value of Diffusion Weighted Imaging In Premature Infants With Punctate White Matter Damage.J Clin Radio,2010,29(4):515-518.祁英,王晓明.扩散加权成像在早期诊断早产儿局灶性脑白质损伤及其预后的价值.临床放射学杂志,2010,29(4):515-518.
[16]Ren HP,Zhang L,Ren ZQ,et al.Value of contrast measurement of ESWAN-R2*value in diagnosis of neonatal punctate white matter lesions.Chin J Magn Reson Imaging,2013,4(3):201-205.任慧鹏,张雷,任转琴,等.ESWAN-R2*值对比测量在新生儿局灶性脑白质损伤诊断中的价值.磁共振成像,2013,4(3):201-205.
[17]Mu L,Yang J,Yu BL.Neonatal hypoxic-ischemic encephalopathy:detection with diffusion-weighted and diffusion-tensor MR imaging.Chin J Magn Reson Imaging,2010,1(1):60-64.穆靓,杨健,鱼博浪.磁共振弥散加权及张量技术在新生儿缺血缺氧性脑病中的应用.磁共振成像,2010,(1):60-64.
[18]Wisnowski JL,Blüml S,Paquette L,et al.Altered glutamatergic metabolism associated with punctate white matter lesions in preterm infants.Plos One,2013,8(2):e56880.
[2]Kersbergen KJ,Benders MJ,Groenendaal F,et al.Different patterns of punctate white matter lesions in serially scanned preterm infants.Plos One,2014,9(10):e108904.
[3]de Bruine FT,van den Berg-Huysmans AA,Leijser LM,et al.Clinical implications of MR imaging findings in the white matter in very preterm infants:a 2-year follow-up study.Radiology,2011,261(3):899-906.
[4]Gao J,Zhang YM,SUN QL,et al.White matter variations in preterm and full term neonates with punctate white matter lesions:a diffusion tensor study based on tract-based spatial statistics.Chin J Magn Reson Imaging,2014,5(1):24-29.高洁,张育苗,孙亲利,等.基于纤维束空间统计分析法研究早产及足月新生儿局灶性脑白质损伤的扩散张量成像特点.磁共振成像,2014,5(1):24-29.
[5]Childs AM,Cornette L,Ramenghi LA,et al.Magnetic resonance and cranial ultrasound characteristics of periventricular white matter abnormalities in newborn infants.Clin Radiol,2001,56(8):647-655.
[6]Cornette L,Tanner S,Ramenghi L,et al.Magnetic resonance imaging of the infant brain:anatomical characteristics and clinical significance of punctate lesions.Arch Dis Child Fetal Neonatal Ed,2002,86(3):171-177.
[7]Tortora D,Panara V,Mattei PA,et al.Comparing 3T T1-weighted sequences in identifying hyperintense punctate lesions in preterm neonates.AJNR Am J Neuroradiol,2015,36(3):581-586.
[8]Nanba Y,Matsui K,Aida N,et al.Magnetic resonance imaging regional T1 abnormalities at term accurately predict motor outcome in preterm infants.Pediatrics,2007,120(1):e10-19.
[9]Cote CJ,Wilson S.Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures:an update.Pediatrics,2006,118(6):2587-2602.
[10]Rutherford MA,Supramaniam V,Ederies A,et al.Magnetic resonance imaging of white matter diseases of prematurity Neuroradiology,2010,52(6):505-521.
[11]Niwa T,de Vries LS,Benders MJ,et al.Punctate white matter lesions in infants:new insights using susceptibility-weighted imaging.Neuroradiology,2011,53(9):669-679.
[12]Nossin-Manor R,Chung AD,Morris D,et al.Optimized T1-and T2-weighted volumetric brain imaging as a diagnostic tool in very preterm neonates.Pediatric Radiology,2011,41(6):702.
[13]Wintersperger BJ,Runge VM,Biswas J,et al.Brain tumor enhancement in MR imaging at 3 Tesla:comparison of SNR and CNR gain using TSE and GRE techniques.Invest Radiol,2007,42(8):558-563.
[14]Edelman RR,Dunkle EI.Rapid whole-brain magnetic resonance imaging with isotropic resolution at 3 Tesla.Invest Radiol,2009,44(1):54-59.
[15]Qi Y,Wang XM.Early Diagnostic and Prognostic Value of Diffusion Weighted Imaging In Premature Infants With Punctate White Matter Damage.J Clin Radio,2010,29(4):515-518.祁英,王晓明.扩散加权成像在早期诊断早产儿局灶性脑白质损伤及其预后的价值.临床放射学杂志,2010,29(4):515-518.
[16]Ren HP,Zhang L,Ren ZQ,et al.Value of contrast measurement of ESWAN-R2*value in diagnosis of neonatal punctate white matter lesions.Chin J Magn Reson Imaging,2013,4(3):201-205.任慧鹏,张雷,任转琴,等.ESWAN-R2*值对比测量在新生儿局灶性脑白质损伤诊断中的价值.磁共振成像,2013,4(3):201-205.
[17]Mu L,Yang J,Yu BL.Neonatal hypoxic-ischemic encephalopathy:detection with diffusion-weighted and diffusion-tensor MR imaging.Chin J Magn Reson Imaging,2010,1(1):60-64.穆靓,杨健,鱼博浪.磁共振弥散加权及张量技术在新生儿缺血缺氧性脑病中的应用.磁共振成像,2010,(1):60-64.
[18]Wisnowski JL,Blüml S,Paquette L,et al.Altered glutamatergic metabolism associated with punctate white matter lesions in preterm infants.Plos One,2013,8(2):e56880.