增强T1W-FLAIR结合BLADE技术对脑转移瘤的诊断价值

Application of enhanced T1WI-FLAIR combination with BLADE technique to diagnosis brain metastases

目的探讨对比增强液体衰减反转恢复序列(FLAIR)结合刀锋伪影纠正(BLADE)技术对脑转移瘤的诊断价值。方法 25例脑转移瘤患者行增强前后自旋回波T1WI、T1WI-FLAIRBLADE和增强后T1WI-FLAIR扫描。因增强后施加流动补偿和改变编码方向序列仍存在不足,故不在本次统计之内。增强后随机扫描SE-T1WI、T1WI-FLAIRB LADE及T1WI-FLAIR序列,计数各种序列上转移瘤的数目,并行图像伪影评价。结果 25例患者共有101个转移灶。SE-T1WI图像发现10个假阳性病灶,其中6个位于幕上,4个位于幕下;15个假阴性病灶,均位于幕下,这些病灶认为与血管搏动伪影有关。T1WI-FLAIRB LADE图像未见假阳性病灶;发现2个假阴性病灶,因转移瘤太小所致。对伪影行4级评分,0分代表没有伪影,1分代表轻度伪影,2分代表中度伪影,3分代表严重伪影。所有T1WI-FLAIRB LADE图像的评分均为0,而对SE-T1WI图像评分为3分4例,2分6例,两序列图像质量比较有显著差异(p<0.01)。结论增强T1WI-FLAIRBLADE序列在脑转移瘤的诊断中有一定价值,尤其是对颅底及皮层脑表面的病灶,以及可以避免由于轻微运动引起的伪影和假象,有望代替常规SE-T1WI序列。

Objective To evaluate value of contrast-enhanced FLAIR combined with BLADE technique to diagnosis of brain metastases.Methods Twenty-five patients with brain metastases were examined with spin-echo T1WI,T1WI-FLAIR BLADE scans before and after enhanced and enhanced T1WI-FLAIR scans.Count on the number of metastases and evaluate the artifact in each sequence.Results Twenty-five patients with 101 metastatic lesions were counted.SE-T1WI found 10 false-positive cases,six lesions are located in the supratentorial and 4 in the next screen;fifteen false negative lesions were located screen,these lesions were considered related to vascular pulsation artifact.No false-positive lesions and two false negative lesions were displayed on T1WI-FLAIR BLADE image,false-negative lesions caused by too small of metastases.Artifact score line 4,with 0 score represent no artifacts,one,two,three score indicate mild to moderate and serious artifacts respectively;all T1WI-FLAIR BLADE image score was 0,while SE-T1WI image score was 3 in 4 patients,4 in 6 patients,image quality between the two series were significantly different（p 0.01）.Conclusion Enhanced T1WI-FLAIR BLADE sequences in the diagnosis of brain metastases play an important role,especially the tumor in the surface of the skull base and brain cortex,as well as minor artifacts caused by motion and illusion,it is expected to replace conventional SE-T1WI sequences.