TSE-DWI序列在头部金属植入物的临床应用价值

Clinical Application Value of TSE-DWI Sequence in Craniofacial Metal Implants

目的:探讨TSE-DWI序列在头部金属植入物的临床应用价值。方法:前瞻性选取拟行颅脑MR检查且存在头部金属植入物的患者15例,分别对患者进行基于快速自旋回波(TSE)和平面回波(EPI)两种不同扩散成像(DWI)序列进行扫描,比较分析两组序列扫描所得图像小脑半球ADC值和信噪比,由2名高年资放射医师对两组序列扫描所得的图像进行主观质量评分。结果:15例患者,11例EPI-DWI成像图像变形严重,无法清晰显示颅脑结构,4例可显示部分颅脑层面;而TSE-DWI成像13例可清晰显示。EPI-DWI序列的信噪比为21.73±6.94,TSE-DWI序列的信噪比为31.80±8.63,两者之间有统计学意义(P<0.01,t=-4.949)。EPI-DWI序列、TSE-DWI序列在小脑层面感兴趣取测得的ADC值分别为(0.72±0.06)×10^(-3)mm^(2)/s、(0.76±0.06)×10^(-3)mm^(2)/s,差异有统计学意义(t=-4.011,P<0.01)。EPI-DWI序列、TSE-DWI序列图像质量主观评分分别为1.9±0.8、3.4±0.7,差异有统计学意义(Z=-3.228,P=0.01)。EPI-DWI序列的扫描时间为60s,TSE-DWI序列的扫描时间为180s。结论:在头部存在金属植入物时TSE-DWI成像图像基本无变形,信噪比较EPI-DWI序列高,能准确反映病灶的位置及形态,可以取代常规EPI-DWI扫描。

Objective:To investigate the clinical value of TSE-DWI sequence in metal implants for the head.Methods:15 patients with metal implants were prospectively selected for MR examination.Patients were treated with DWI based on TSE and EPI respectively.The ADC values and signal-to-noise ratio of the cerebellar hemispheres were compared and analyzed in the two sets of images.The subjective quality of the two sets of images was scored by two senior radiologists.Results:The 15 patients,11 patients were badly deformed and could not clearly display the brain structure,and 4 patients could display part of the brain.TSE-DWI imaging can clearly show 13 cases.The signal-to-noise ratio of EPI-DWI sequence was 21.73±6.94,and that of TSE-DWI sequence was 31.80±8.63,with statistical significance(P<0.01,t=-4.949).The ADC value of the same part of EPI-DWI sequence was(0.72±0.06)×10^(-3)mm^(2)/s.The ADC value of normal cerebellar hemisphere on the cerebellar level of TSE-DWI sequence was(0.76±0.06)×10^(-3)mm^(2)/s,with statistical significance(P<0.01,t=-4.011).The subjective score of EPI-DWI sequence was 1.9±0.8,and that of TSE-DWI sequence was 3.4±0.7,indicating statistical significance(P=0.01,Z=-3.228).The scanning time of EPIDWI sequence was 60s,and that of TSE-DWI sequence was 180s.Conclusion:TSE-DWI imaging images with metal implants in the head are basically deformable,and the SNR is high in EPI-DWI sequence,which can accurately reflect the location and morphology of lesions,and can replace conventional EPI-DWI scanning.