SWI与DTI联合成像在急性颈髓损伤诊断中的应用价值
发布时间：2019-02-25 15:59
【摘要】：目的： 初步研究应用磁敏感加权成像（Susceptibility WeightedImaging,SWI）与弥散张量成像（Diffusion Tensor Imaging,DTI）序列在急性脊髓损伤的诊断中的临床应用价值。比较常规MRI序列与SWI序列对急性脊髓损伤出血灶的检出率及DTI扫描序列各参数（包括FA值和ADC值）对急性颈髓损伤的定量分析。 资料与方法： 收集2013年7月—2014年3月因急性颈髓损伤来我院进行治疗的患者18例，所有患者均经临床医生根据其外伤史、临床症状及体征初步判断为急性颈髓损伤患者。应用西门子3.0T超导磁共振，头颈联合线圈分别行常规MRI扫描、SWI及DTI扫描,而MR-DTI则选用单次激发快速自旋回波（Single-shot Echo-palnar Imaging,EPI）,选择15个梯度方向，b值选取0、500s/mm2，行矢状位扫描，并根据常规T2WI矢状面进行定位，即决定被分析的层面；分别测量急性脊髓损伤患者受损区域及受损区域水平以上区域的FA值和ADC值，分别比较两者的差异，然后进行统计学分析。利用DTT脊髓重建技术对受损的颈髓纤维束重建，进行观察。SWI序列采用横轴位扫描，观察受损颈髓的受损区域是否有异常低信号，并与常规MR扫描序列对比，评价其对出血灶的检出率。 结果： 磁共振常规MR序列、SWI及DTI序列对受损颈髓进行扫描后，在DTI扫描序列上，其相应颈髓损伤节段的FA值、ADC值与其相对应的颈髓受损区以上正常区域的FA值和ADC值比较均有明显降低，进行统计学分析，其差异有意义。部分在常规MR序列上阴性的患者，在DTI扫描后可见异常信号，，并且其所测得FA值和ADC值均有降低，证明DTI序列对颈髓损伤的情况较常规MR序列更敏感、更客观。 利用DTT进行颈髓重建，观察受损颈髓纤维束走形及其完整性，观察其纤维束有无扭曲、受压、截断等改变。 在SWI扫描序列上，7例患者在常规MRI序列上未显示异常高信号区，其相应颈髓节段在SWI上可见小点状、小斑片状低信号；8例患者在常规MRI序列及SWI上均显示异常信号；3例患者在常规MRI序列及SWI上均未见异常信号出现。经统计学分析，两者对受损颈髓出血灶的检出率方面，统计学差异有意义。 结论： 1. DTI扫描能证明，急性颈髓损伤患者的颈髓受损区域的FA值和ADC值均有明显下降，可对急性颈髓损伤患者做出客观的定性、定量的评估。 2. DTT可直观显示颈髓纤维束的完整性和受损情况。 3. SWI较常规MR序列发现颈髓损伤后出血灶敏感。
[Abstract]:Aim: to study the clinical value of magnetic sensitivity weighted imaging (Susceptibility WeightedImaging,SWI) and diffusion Zhang Liang imaging (Diffusion Tensor Imaging,DTI) in the diagnosis of acute spinal cord injury. To compare the detection rate of acute spinal cord injury with conventional MRI sequence and SWI sequence and quantitative analysis of acute cervical spinal cord injury by DTI scan sequence parameters including FA value and ADC value. Materials and methods: from July 2013 to March 2014, 18 patients with acute cervical spinal cord injury were treated in our hospital. All patients were treated by clinicians according to their traumatic history. Clinical symptoms and signs were initially identified as acute cervical spinal cord injury patients. Using Siemens 3.0T superconducting magnetic resonance, the head and neck coils were scanned by conventional MRI, SWI and DTI respectively, while MR-DTI was performed with single shot fast spin echo (Single-shot Echo-palnar Imaging,EPI) and 15 gradient directions. B value was 0 500 s / mm 2, sagittal scan was performed, and the sagittal plane was located according to the conventional T2WI, that is to say, the plane to be analyzed was determined. FA and ADC values were measured in the injured area and above the level of the injured area in patients with acute spinal cord injury, and the differences between them were compared, and then statistical analysis was carried out. The DTT spinal cord reconstruction technique was used to reconstruct the injured cervical spinal fiber bundle. The abnormal low signal was observed in the damaged area of the injured cervical spinal cord by transverse axial scan, and compared with the conventional MR scan sequence. To evaluate the detection rate of bleeding foci. Results: after conventional MR, SWI and DTI sequences were used to scan the injured cervical spinal cord, the FA values of the corresponding cervical spinal cord injured segments were measured on the DTI sequence. The FA value and ADC value of ADC were significantly lower than those of normal area above the corresponding cervical spinal cord injury area, and the difference was significant. In some patients who were negative on conventional MR sequences, abnormal signals were observed after DTI scanning, and FA and ADC values were decreased, which proved that DTI sequences were more sensitive and objective to cervical spinal cord injury than conventional MR sequences. DTT was used to reconstruct the cervical spinal cord. The shape and integrity of the injured cervical spinal fiber bundle were observed, and the changes of the injured cervical spinal fiber bundle such as distortion, compression, truncation and so on were observed. On SWI scan sequence, 7 patients did not show abnormal high signal region on conventional MRI sequence, and the corresponding cervical spinal cord segment showed small dot and patchy low signal on SWI, 8 patients showed abnormal signal on routine MRI sequence and SWI, and 8 patients showed abnormal signal on routine MRI sequence and SWI sequence. There was no abnormal signal on routine MRI sequence and SWI in 3 patients. Statistical analysis showed that the detection rate of the injured cervical spinal cord hemorrhage foci was statistically significant between the two groups. Conclusion: 1. DTI scan showed that FA and ADC in the injured area of the cervical spinal cord were significantly decreased in the patients with acute cervical spinal cord injury, and could be evaluated objectively and quantitatively in the patients with acute cervical spinal cord injury. 2. DTT can visualize the integrity and damage of the cervical spinal fiber bundle. 3. SWI was more sensitive than conventional MR sequence in detecting hemorrhage after cervical spinal cord injury.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R651.2;R445.2
[Abstract]:Aim: to study the clinical value of magnetic sensitivity weighted imaging (Susceptibility WeightedImaging,SWI) and diffusion Zhang Liang imaging (Diffusion Tensor Imaging,DTI) in the diagnosis of acute spinal cord injury. To compare the detection rate of acute spinal cord injury with conventional MRI sequence and SWI sequence and quantitative analysis of acute cervical spinal cord injury by DTI scan sequence parameters including FA value and ADC value. Materials and methods: from July 2013 to March 2014, 18 patients with acute cervical spinal cord injury were treated in our hospital. All patients were treated by clinicians according to their traumatic history. Clinical symptoms and signs were initially identified as acute cervical spinal cord injury patients. Using Siemens 3.0T superconducting magnetic resonance, the head and neck coils were scanned by conventional MRI, SWI and DTI respectively, while MR-DTI was performed with single shot fast spin echo (Single-shot Echo-palnar Imaging,EPI) and 15 gradient directions. B value was 0 500 s / mm 2, sagittal scan was performed, and the sagittal plane was located according to the conventional T2WI, that is to say, the plane to be analyzed was determined. FA and ADC values were measured in the injured area and above the level of the injured area in patients with acute spinal cord injury, and the differences between them were compared, and then statistical analysis was carried out. The DTT spinal cord reconstruction technique was used to reconstruct the injured cervical spinal fiber bundle. The abnormal low signal was observed in the damaged area of the injured cervical spinal cord by transverse axial scan, and compared with the conventional MR scan sequence. To evaluate the detection rate of bleeding foci. Results: after conventional MR, SWI and DTI sequences were used to scan the injured cervical spinal cord, the FA values of the corresponding cervical spinal cord injured segments were measured on the DTI sequence. The FA value and ADC value of ADC were significantly lower than those of normal area above the corresponding cervical spinal cord injury area, and the difference was significant. In some patients who were negative on conventional MR sequences, abnormal signals were observed after DTI scanning, and FA and ADC values were decreased, which proved that DTI sequences were more sensitive and objective to cervical spinal cord injury than conventional MR sequences. DTT was used to reconstruct the cervical spinal cord. The shape and integrity of the injured cervical spinal fiber bundle were observed, and the changes of the injured cervical spinal fiber bundle such as distortion, compression, truncation and so on were observed. On SWI scan sequence, 7 patients did not show abnormal high signal region on conventional MRI sequence, and the corresponding cervical spinal cord segment showed small dot and patchy low signal on SWI, 8 patients showed abnormal signal on routine MRI sequence and SWI, and 8 patients showed abnormal signal on routine MRI sequence and SWI sequence. There was no abnormal signal on routine MRI sequence and SWI in 3 patients. Statistical analysis showed that the detection rate of the injured cervical spinal cord hemorrhage foci was statistically significant between the two groups. Conclusion: 1. DTI scan showed that FA and ADC in the injured area of the cervical spinal cord were significantly decreased in the patients with acute cervical spinal cord injury, and could be evaluated objectively and quantitatively in the patients with acute cervical spinal cord injury. 2. DTT can visualize the integrity and damage of the cervical spinal fiber bundle. 3. SWI was more sensitive than conventional MR sequence in detecting hemorrhage after cervical spinal cord injury.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R651.2;R445.2
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相关期刊论文 前9条
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