3D MEDIC和3D SPACE磁共振神经成像在腰骶丛神经根的一致性对比研究

A comparative study on the consistency of 3D MEDIC and 3D SPACE magnetic resonance neurography imaging in lumbosacral plexus nerve roots

目的验证三维多回波数据联合成像(three dimensional multi-echo data imagine combination with selective water excitation,3D MEDIC WE)和三维快速自旋回波成像(three dimensional sampling perfection with application optimized contrasts by using different flip angle evolution,3D SPACE STIR)序列在腰骶丛神经根成像中的可行性和重复性。方法将55例受试者分为腰椎无异常表现的正常对照组(20例)、单纯性腰椎间盘突出症(lumbar disc herniation,LDH)组(20例)和慢性炎性脱髓鞘性多发性神经根神经病症(chronic inflammatory demyelinating polyradiculoneuropathy,CIDP)组(15例),分别应用两种腰骶丛神经根成像,评价图像质量参数信噪比(signal to noise ratio,SNR)、对比噪声比(contrast to noise ratio,CNR)和对比度(contrast ratio,CR),并验证正常对照组、CIDP组和LDH组测量神经根直径的一致性。结果两序列测得神经根直径的一致性较高(正常组r=0.95,CIDP组r=0.99,LDH组r=0.97,P<0.001),图像质量评价指标显示,3D SPACE STIR序列在SNR、CNR和CR三项指标中占优,3D MEDIC WE定性评估图像质量评分较高。两序列均能清晰显示正常腰骶丛神经根、病变所致的弥漫性形态增粗神经根以及间盘突出受挤压变形的神经根。结论3D MEDIC WE和3D SPACE STIR序列可应用于腰骶丛神经根成像,两序列对正常和异常形态、走行的神经根评估具备很高的可行性和重复性。综合考量临床图像的定性、定量评价,可择优选择恰当的序列为腰骶丛神经根成像提供影像支持。

Objective To validate the feasibility and reproducibility of three dimensional multi-echo data imagine combination with selective water excitation(3D MEDIC WE)and three-dimensional sampling perfection with application optimized contrasts by using different flip angle evolution(3D SPACE STIR)sequence in lumbosacral plexus nerve root imaging.Methods Fifty-five subjects were undergone with two magnetic resonance neurography(MRN)sequences of lumbosacral plexus nerve roots to evaluate the signal to noise ratio(SNR),contrast to noise ratio(CNR)and contrast ratio(CR)of image quality parameters,and to validate the consistency of measurement of nerve root diameter in normal control(NC)group,chronic inflammatory demyelinating polyradiculoneuropathy(CIDP)group and lumbar disc herniation(LDH)group,respectively.Results The consistency of nerve root diameter measured by the two MRN sequences was higher(r=0.95 in NC group,r=0.99 in CIDP group,r=0.97 in LDH group,P<0.001).The image quality evaluation index showed that 3D space sequence was superior in the three indexes of SNR,CNR and CR,and the image quality score of 3D medic qualitative evaluation was higher.Both the two sequences can clearly show the normal lumbosacral plexus nerve root,the diffuse morphological thickening nerve root and the compressed nerve root caused by the disc herniation.Conclusion 3D MEDIC and 3D SPACE sequences can be used in the assessment of lumbosacral plexus nerve root imaging.The two sequences have high feasibility and reproducibility in the evaluation of normal and abnormal shape and course of nerve root.Considering the all-round evaluation of clinical images,we can choose the best sequence to provide image support.