视网膜母细胞瘤中TSE-DWI与EP-DWI的相关性分析及临床应用价值

Single-shot turbo spin-echo diffusion-weighted imaging versus echo planar imaging for evaluating retinoblastoma

目的对比EP-DWI评估TSE-DWI对视网膜母细胞瘤(RB)瘤灶的定量分析的有效性及临床实用价值。方法对31例RB进行基于快速自旋回波(TSE)和平面回波(EP)的两种不同扩散成像(DWI)序列扫描,总计得到34个患眼的扩散加权图像,参照常规增强序列中的肿瘤强化区域,测量肿瘤病灶最大截面面积及表观弥散系数(ADC值),并进行统计学分析。结果在TSE-DWI所得RB图像上,无明显磁敏感伪影及形变;肿瘤瘤灶实质区域的最大截面面积:EPDWI测量值自33~159mm2[均值±标准差:(87.9±34.3)mm2],TSE-DWI测得值自38~161mm2[均值±标准差:(98.5±39.6)mm2],相关系数r=0.829,P<0.05;肿瘤瘤灶实质区域的ADC值:EP-DWI测量值自0.50×10^(-3)mm^2/s^1.39×10^(-3)mm^2/s[均值±标准差:(0.87±0.19)×10^(-3)mm^2/s],TSE-DWI测得值自0.49×10^(-3)mm^2/s^1.25×10^(-3)mm^2/s[均值±标准差:(0.76±0.23)×10^(-3)mm^2/s],相关系数r=0.376,P<0.05。结论基于TSE的DWI,能够避免磁敏感伪影和形变,精确地进行RB瘤灶的定量分析,具有非常重要的临床应用价值。

Objective To investigate feasibility of TSE-DWI in the evaluation of retinoblastoma compared to EP imaging.Methods Thirty-one patients with retinoblastoma(n=34 eyes)were assessed with conventional MR images and DWI(ADC maps).TSE-DWI and EP-DWI were performed with b-values of 0 and 1 000 s/mm 2.ADC maps were measured for enhancing tumor tissue in the level of maximum cross section and the area of the section also was measured.All data were analyzed with the Statistical Package for the Social Science software package.Results Intraocular lesions were clearly visualized on the TSE Diffusion-Weighted images without obvious susceptibility artifacts and geometrical distortion,whereas,all showed deformity on EP images.On the TSE-DWI,the areas of enhancing tumor tissues in the level of maximum cross section ranged from 38 mm 2 to 161 mm 2(mean±SD:98.5±39.6 mm 2).On the EP images,the areas ranged from 33 mm 2 to 159 mm 2(87.9±34.3)mm 2.There was a significant correlation in the areas measurement between the TSE-DWI and EP imaging(r=0.829,P<0.05).On the TSE-DWI,the ADCs of the lesions ranged from 0.49×10-3 mm 2/s to 1.25×10-3 mm 2/s(mean±SD:0.76±0.23×10-3 mm 2/s).On the EP images,the ADCs ranged from 0.50×10-3 mm 2/s to 1.39×10-3 mm 2/s(0.87±0.19×10-3 mm 2/s).There was a significant correlation in ADC measurement between the TSE-DWI and EP imaging(r=0.376,P<0.05).Conclusion TSE-DWI can achieve high quality images without distortion and less susceptibility artifacts compared to EP images in retinoblastomas.The technique may have the important clinical application value to assess the tumor tissues with the precise quantitative analysis.