糖尿病足磁共振增强成像优化方案的探讨

Optimal Protocol of MR Contrast Imaging in Diabetic Foot

目的探讨糖尿病足磁共振增强成像的优化方案。方法纳入20例糖尿病足患者,对患足进行增强后的三维小角度激发快速梯度回波血管成像序列(3DFLASH-MRA)、三维容积内插法屏气序列(3DVIBE)-水激励(WE)、T1WI二维自旋回波(2DSE)-压脂(FS)、T1WI二维快速自旋回波(2DTSE)-FS、T1 WI二维小角度激发快速梯度回波(2DFLASH)-FS序列的扫描,比较各序列在足部血管显示,静脉重叠,关节软骨显示,足底皮肤、跟骨、趾短屈肌、足背动脉、距跟关节软骨的信噪比(SNR)及对比率(CR)的差异。结果①在足部血管显示及静脉重叠评价方面,3DFLASH-MRA优于其余序列(P<0.05);②在对关节软骨的显示方面,3DVIBE-WE序列优于2DSE-FS、2DTSE-FS、2DFLASH-FS(P<0.05);③足底皮肤、跟骨、趾短屈肌、足背动脉、距跟关节软骨的CR及足底皮肤、足背动脉、距跟关节软骨的SNR在3D VIBE-WE序列上高于其余序列(P<0.05)。结论 3DVIBE-WE序列应作为糖尿病足增强T1WI序列的首选序列,并在足部血管显示方面能作为3DFLASH-MRA的补充序列。

Objective To identify the optimal protocol of MR contrast imaging in diabetic foot. Methods 20 patients with diabetic feet were enrolled and examined with 3D FLASH-MRA, 3D VIBE-WE, 2D SE-FS, 2D TSE- FS and 2D FLASH-FS at a 1.5T MR scanner for vascular changes in feet. Their effectiveness in displaying blood vessels, venous aliasing and articular cartilage, as well as the signal-to-noise ratio （SNR） and contrast ratio （CR） of plantar skins calcaneus, flexor digitorum brevis, dorsal artery, and talocalcaneat joint cartilage in diabetic feet were compared. Results ① 3D FLASH-MRA was better in displaying blood vessels and venous aliasing than the others （P〈0.05）; ② 3D VIBE-WE was better in displaying articular cartilage than 2D SE-FS, 2D TSE-FS and 2D FLASH-FS （P〈0.05） ;② 3D VIBE-WE had higher SNR and CR of plantar skins, dorsal artery, talocalcaneal joint cartilage, caleaneus, and flexor digitorum brevis than the others （P〈0.05）. Conclusion 3D VIBE-WE is the preferred sequence for T1 weighted imaging with contrast in diabetic feet. It can also serve as the supplemental sequence of 3D FLASH-MRA in MR angiography.