增强fFLAIR序列对颅内疾病的诊断价值

Contrast-enhanced Fast FLAIR Sequence in the Diagnosis of the Intracranial Diseases

目的:探讨增强fFLAIR序列在颅内疾病诊断中的应用价值。方法:42例颅内疾病患者(男性34例,女性8例,年龄11～87岁,平均41.8岁)分成三组:脑膜病变组12例(细菌性脑膜炎6例,病毒性脑膜炎3例,结核性脑膜炎1例,脑膜转移瘤2例);硬膜下病变组10例(血肿7例,积液3例);脑实质病变组20例(脑实质内转移瘤7例,脑梗死6例,胶质瘤4例,血管母细胞瘤2例,脑挫伤1例)。在0.5T机器上完成平扫fFLAIR和增强T1WI、fFLAIR检查,由两位资深影像科医师盲法比较三个序列对三组病变检出病灶的能力。采用χ2检验评价样本率差别,界值取P<0.05。结果:增强fFLAIR序列比平扫fFLAIR和增强T1WI序列检出更多的脑膜病变(χ2=24.373,P<0.05)和硬膜下病变(χ2=11.725,P<0.05),但检出脑实质病变无明显差异(χ2=1.287,P>0.05)。结论:增强fFLAIR较平扫fFLAIR和增强T1WI序列检出更多的脑膜和硬膜下病灶,对颅内病变的诊断有一定的补充价值,值得推荐。

Purpose： To evaluate the diagnostic value of contrast - enhanced fFLAIR sequence in the diagnosis of the intracranial diseases. Methods： Forty- two patients with intracranial diseases （34 male and 8 female, 11 - 87 years, average 41.8） were divided into three groups： the meningeal group （6 bacterial meningitises, 3 viral meningitises, 1 tuberculous meningitises, 2 meningeal metastases）, the subdural group （7 hematomas, 3 effusions）, and the brain group（7 brain metastases, 6 infarctions, 4 gliomas, 2 hemangioblastomas, 1 cerebral contusion） . The uncontrasted fFLAIR, contrastenhanced T1WI and fFLAIR were applied in all patients on a 0.5T scanner. Two experienced radiologists blinded compared the images of three sequences in the three groups to find the ability of detection. The sample rate was assessed with chi - square statistics and the significant threshold was set as P 〈 0.05. Results： There were more meningeal lesions（X^2 = 24. 373） and subdural lesious（X^2 = 11. 725） detected with contrast - enhanced fFLAIR sequence than that with precontrast fFLAIR and contrasted T1WI. To the brain lesions, no significant difference was found in all three sequences（X^2 = 1. 287, P 〉 0.05） . Conclusion： Contrast- enhanced fFLAIR could reveal more meningeal and subdural lesions than precontrast fFLAIR and enhanced T1WI. We recommended such a sequence would be a useful supplement for MRI of intracranial lesions.