顯影劑前後磁共振三維短時間反轉恢復序列最大強度投影對臂神經叢之研究

A Study of Comparisons between Pre- and Post-contrast Maximum Intensity Projection Images Acquired by MR 3D-T2WI-STIR Sequence for Brachial Plexus

陳文昌(Wen-Chang Chen) ； 王士崇(Shih-Chorng Wang) ； 林秋湧(Chiu-Yung Lin) ； 陳志峰(Chiu-Yung Lin)

《中華放射線技術學雜誌》 38卷4期 (2014/12) Pp. 205-212

摘要

本研究主要是比較磁共振三維短時間反轉恢復序列於施打造影劑前後，影像的訊號雜訊比、對比雜訊比和對比之差異性，以提供臨床使用之適當時機。施打造影劑前與後，做同條件與位置之磁共振三維短時間反轉恢復脈衝序列掃描，由三位量測者量測最大強度投影影像之訊號強度，先求其量測間變異信度之組內可靠性來分析其信度；再以成對樣本T檢定分析顯影前與後兩組臂神經和神經周圍組織，影像的訊號雜訊比、對比雜訊比和對比。成對樣本T檢定發現臂神經訊號雜訊比顯影後高於顯影前（p＜0.001），臂神經周圍組織訊號雜訊比顯影前高於顯影後（p＜0.001），在臂神經與神經周圍組織之對比雜訊比顯影後高於顯影前（p＜0.001），對比是顯影後高於顯影前（p＜0.001）。Gd-DTPA造影劑確實能提升磁共振三維短時間反轉恢復序列對臂神經叢之影像的訊號雜訊比、對比雜訊比和對比，故建議臨床於施打造影劑後再做此脈衝序列，讓臂神經叢更能完整且清楚的呈現出來，以增加臨床之診斷應用價值。

關鍵字

磁共振三維短時間反轉恢復序列 ； 臂神經叢 ； 最大強度投影

並列摘要

We make a comparison between pre- and post-contrast maximum intensity projection (MIP) images acquired by magnetic resonance (MR) three-dimensional T2-weighted short tau inversion recovery (3D-T2WI-STIR) sequence for brachial plexus in several aspects, including signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and contrast-radio (CR). A total of 30 cases with brachial plexus disease were included Images were acquired by a 3.0 Tesla MR system. There were three observers assigned to measure the pre- and post-contrast MIP images of MR 3D-T2WI-STIR sequence for comparison. After the inter-observer reliability was checked, the differences in SNR, CNR and CR between pre- and post-contrast MIP images were examined by the paired-T test.In MR 3D-T2WI-STIR MIP images, it was found that SNRs in brachial plexuses and surrounding tissues had different changes after a contrast agent injection. In the post-contrast condition, the SNR would increase in the brachial plexus and it would decrease in surrounding tissues respectively. The CNR and CR between the brachial plexuses and surrounding tissues were also sgnificantly increased in post-contrast MIP images (both P ＜0.001). Contrast agent injections for 3D-T2WI-STIR MIP images can elevate SNR, CNR and CR of brachial plexus. Clinically the post-contrast technique is suggested when performing this sequence for brachial plexus. Further multiplanar reconstructions (MPR) technique for 3D images owns advantages of post-processing accessibility. Therefore, post-contrast MIP images and the MPR technique might gain more diagnostic accuracies in the future for evaluating brachial plexus lesions.

並列關鍵字

MR 3D-T2WI-STIR ； Brachial plexus ； Maximum Intensity Projection