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.
引文
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