3D STIR SPACE序列在坐骨神经成像中的价值研究

The Application Value of 3D STIR SPACE Sequence in Sciatic Nerve Imaging

目的探讨钆对比剂增强三维反转恢复快速自旋回波(3D STIR SPACE)序列在坐骨神经成像中的可行性与应用价值。方法收集30例患者使用3D STIR SPACE序列同时行平扫和增强扫描进行坐骨神经成像。所有图像进行最大密度投影MIP重建,且由两位高年资放射医师对MIP图进行神经显示评分和背景抑制效果评分,并在原始图中测量坐骨神经的信噪比SNR和神经与肌肉的对比噪声比CNR。坐骨神经显示评分及背景抑制评分采取Wilcoxon秩和检验,同时对增强和平扫图像的信噪比、对比噪声比进行独立样本t检验。结果平扫图像中坐骨神经显示评价评分为0.77±0.58分,背景抑制效果评价评分为1.26±0.45分;增强图像坐骨神经显示评分为1.86±0.36分,背景抑制评分为2.79±0.39分,增强序列的背景抑制效果明显好于平扫序列(P<0.01)。平扫与增强图像中神经与肌肉CNR分别为23.61±8.10和37.38±12.49,SNR分别为42.16±10.38和49.02±11.96,增强序列提高了神经对肌肉的对比噪声比(P<0.01)但整体SNR提高并不明显(P=0.051)。结论增强3D STIR SPACE序列呈现出了较好的背景抑制效果,可以很好的显示坐骨神经走行及远端分支。

Objective To investigate the feasibility and application value of gadolinium enhanced 3D SPACE STIR sequence in sciatic nerve imaging.Methods 30 patients both underwent sciatic nerve imaging using plain and enhanced 3D SPACE STIR sequences.All images were reconstructed by maximum intensity projection MIP.Two senior radiologists scored neural display and background suppression effect on the MIP images.The sciatic nerve signal to noise ratio(SNR)and contrast noise ratio(CNR)between sciatic nerve and muscle were measured in the original images.The visibility score of sciatic nerve and background suppression score were compared by Wilcoxon Rank Sum Test.The CNR and SNR result of subjects received both enhanced and plain imaging were compared with independent-samples T test.Results On plain scan,the evaluation score of sciatic nerve display was 0.77±0.58,and the evaluation score of background inhibition was 1.26±0.45.The sciatic nerve display score of enhanced image was 1.86±0.36,and the background inhibition score was 2.79±0.39.The background inhibition effect of enhanced sequence was significantly better than that of plain scan sequence(P<0.01).The CNR of nerve and muscle was 23.61±8.10 and 37.38±12.49,and SNR was 42.16±10.38 and 49.02±11.96 in plain and enhanced images.The contrast to noise ratio of nerve and muscle was improved by enhanced sequence(P<0.01),but the overall SNR was not significantly improved(P=0.051).Conclusion Compared with plain scanning,enhanced 3D SPACE STIR shows better background suppression and can display sciatic nerve progression and distal branches more clearly.