高分辨三维快速扰相梯度回波序列MR成像显示胫神经及腓总神经

Visualization of the Tibial and Common Peroneal Nerve Using High-resolution Three-dimensional Fast Spoiled Gradient Recalled Echo Sequence MRI

目的探讨高分辨三维快速扰相梯度回波(3D-FSPGR)序列显示膝关节区域胫神经及腓总神经的临床应用价值。方法随机收集20名健康志愿者,采用3D-FSPGR序列行单侧膝关节MRI扫描,分别分析胫神经及腓总神经显示率、图像质量主观评分、神经的信号噪音比(SNR)、神经与周围脂肪对比噪音比(CNR)。结果3D-FSPGR序列图像胫神经及腓总神经的显示率均为100%,图像中脂肪组织及骨骼呈明显的低信号,肌肉呈等信号,腓总神经呈相对于肌肉组织的等信号,胫神经信号略低于腓总神经;两个观察者对胫神经图像质量评分分别为(3.90±0.308&3.85±0.366,κ=0.774),腓总神经图像质量评分分别为(3.80±0.410&3.65±0.489,κ=0.634),两观察者图像质量主观评分一致性较强;相同层面腓总神经SNR及CNR高于胫神经,SNR(TN:CPN=55.90±14.777&78.22±22.937,P=0.000),C N R(T N:C P N=24.31±8.303&46.63±15.523,P=0.000),P值小于0.05两者差异有统计学意义。结论高分辨轴位3D-FSPGR序列可以清晰显示胫神经、腓总神经解剖及其内部细微神经纤维束。

Objective To explore the value of high-resolution three-dimensional fast spoiled gradient recalled echo sequence(3D-FSPGR)in displaying the tibial and common peroneal nerve.Methods 20 volunteers were scanned unilaterally by a flex medium array coil combined with 3D-FSPGR sequence.The signal characteristics of the tibial nerve and common peroneal nerve were analyzed.The displaying rate of the tibial and common peroneal nerve were evaluated.The image quality and display of the nerve were subjectively scored,and consistency of inter-obsever was assessed.The signal intensity(SI)of the nerves and adjacent adipose tissue were measured.The signal noise ratio(SNR)and contrast to noise ratio(CNR)were calculated.Results The displaying rate of the tibial and common peroneal nerve in 3D-FSPGR were 100%.Compared with adjacent adipose tissue,the tibial and common peroneal nerve all showed hyperintense,compared with the adjacent muscles,common peroneal nerve showed isointensity,the intensity of tibial nerve nerve slightly lower than common peroneal nerve.The tibial and common peroneal nerve showed the better quality scores,which were all about 3 points.The subjective scores for the tibial nerve were 3.90±0.308 and 3.85±0.366,and for the common peroneal nerve were 3.80±0.410 and 3.65±0.489,respectively for observers 1 and 2.Interobserver agreement was good(κ=0.774 for tibial nerve,κ=0.643 for common peroneal nerve).The SNR and CNR of common peroneal nerve were higer than tibial nerve(SNR TN:CPN=55.90±14.777&78.22±22.937,CNR TN:CPN=24.31±8.303&46.63±15.523,P=0.000).Conclusion High-resolution 3D-FSPGR sequence performed high-quality in the tibial and common peronea nerve,and suitable for clinical application.