| 郑恕光,范国光,曲海源,孙文阁.三维容积液体衰减翻转恢复序列在神经精神狼疮中的临床价值[J].中国医学影像技术,2012,28(8):1483~1487 |
| 三维容积液体衰减翻转恢复序列在神经精神狼疮中的临床价值 |
| Clinical value of three-dimensional fluid attenuated inversion recovery sequence in neuropsychiatric systemic lupus erythematosus |
| 投稿时间：2012-02-15 修订日期：2012-04-20 |
| DOI： |
| 中文关键词: 磁共振成像 三维容积液体衰减翻转恢复序列 神经精神狼疮 |
| 英文关键词:Magnetic resonance imaging Three-dimensional fluid attenuated inversion recovery sequence Neuropsychiatric systemic lupus erythematosus |
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| 中文摘要: |
| 目的 通过与常规二维MR序列(T1W、T2W、T2 FLAIR)比较,探讨三维容积液体衰减翻转恢复序列(3D-FLAIR)在神经精神狼疮(NPSLE)脑部病变中的应用价值。 方法 对28例具有脑脊液化验结果的NPSLE患者行T2W、T2 FLAIR、3D-FLAIR轴位平扫,在T1W增强扫描后24~48 h内行T1W及3D-FLAIR轴位、矢状位、冠状位增强扫描。在轴位平扫图像统计脑内直径<6 mm病灶的数量,在增强图像评估有无脑膜病变强化及脑膜病变的强化范围。 结果 28例患者中,25例头部扫描发现异常。25例患者T2W、T2 FLAIR、3D-FLAIR分别发现脑内直径<6 mm异常信号灶为183、213、307个,三者总数的差异有统计学意义(P<0.001),组间比较显示T2W与3D-FLAIR、T2 FLAIR与3D-FLAIR差异均有统计学意义(P均<0.001),T2W与T2 FLAIR差异无统计学意义(P=0.89)。28例患者中,16例脑脊液腰穿结果存在异常,其中T1W、3D-FLAIR增强扫描分别发现脑膜病变强化5例、12例,敏感度分别为31.25%(5/16)、75.00%(12/16),差异有统计学意义(P<0.05)。7例NPSLE患者在3D-FLAIR增强发现脑膜局灶性强化,而在T1W增强未见确切强化。5例NPSLE患者T1W增强发现脑膜病变强化,对比相同层面的3D-FLAIR图像,两者脑膜异常强化范围评分差异有统计学意义(P<0.05)。 结论 3D-FLAIR序列能较T2W、T2FLAIR发现更多直径<6 mm的异常信号灶。在发现NPSLE脑膜异常改变方面,3D-FLAIR增强扫描较常规T1W增强扫描具有优势。 |
| 英文摘要: |
| Objective To investigate the clinical value of three-dimensional fluid attenuated inversion recovery sequence (3D-FLAIR) in detecting brain lesions of neuropsychiatric systemic lupus erythematosus (NPSLE), and compare with conventional two-dimensional magnetic resonance sequences (T1W, T2W, T2 FLAIR). Methods Twenty-eight NPSLE patients with cerebrospinal fluid test results underwent T2W, T2 FLAIR, 3D-FLAIR plain axial scans and T1W, 3D-FLAIR (in 24-48 h after T1W enhanced scan) axial, sagittal, coronal enhanced scans, subsequently. Two independent radiologists made the statistics about the total numbers of brain lesions less than 6 mm in diameter on the three plain axial scan sequences and analyzed whether there were meningeal lesions enhancement, as well as the range of meningeal lesions enhancement on the enhanced images. Results Abnormalities were detected in 25 patients. The number of focal lesions with diameter less than 6 mm detected with T2W, T2 FLAIR, 3D-FLAIR was 183, 213, 307 in 25 patients, respectively (P<0.001). The numbers of the lesions detected between T2W and 3D-FLAIR, T2 FLAIR and 3D-FLAIR had statistical difference (both P<0.001), while no statistical difference was found between T2W and T2 FLAIR (P=0.89). Sixteen patients presented abnormal cerebrospinal fluid results in all 28 patients. Meningeal lesions enhancement had been detected in 5 and 12 patients in T1W, 3D-FLAIR enhancement scan, and the sensitivity was 31.25% (5/16) and 75.00% (12/16), respectively (P<0.05). Focal meningeal abnormal enhancement was detected in 7 NPSLE patients in 3D-FLAIR, but negative in T1W enhanced scan. There was statistical difference in the score of meningeal lesions enhancement range between T1W and corresponding 3D-FLAIR images in 5 NPSLE patients (P<0.05). Conclusion Compared with T2W and T2 FLAIR, 3D-FLAIR can detect more abnormal signal focal lesions in brain. Enhanced 3D-FLAIR is superior to enhanced T1W in detecting meningeal lesions in NPSLE patients. |
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