SWI與DTI聯(lián)合成像在急性頸髓損傷診斷中的應(yīng)用價(jià)值
發(fā)布時(shí)間：2019-02-25 15:59
【摘要】：目的： 初步研究應(yīng)用磁敏感加權(quán)成像（Susceptibility WeightedImaging,SWI）與彌散張量成像（Diffusion Tensor Imaging,DTI）序列在急性脊髓損傷的診斷中的臨床應(yīng)用價(jià)值。比較常規(guī)MRI序列與SWI序列對(duì)急性脊髓損傷出血灶的檢出率及DTI掃描序列各參數(shù)（包括FA值和ADC值）對(duì)急性頸髓損傷的定量分析。 資料與方法： 收集2013年7月—2014年3月因急性頸髓損傷來我院進(jìn)行治療的患者18例，所有患者均經(jīng)臨床醫(yī)生根據(jù)其外傷史、臨床癥狀及體征初步判斷為急性頸髓損傷患者。應(yīng)用西門子3.0T超導(dǎo)磁共振，頭頸聯(lián)合線圈分別行常規(guī)MRI掃描、SWI及DTI掃描,而MR-DTI則選用單次激發(fā)快速自旋回波（Single-shot Echo-palnar Imaging,EPI）,選擇15個(gè)梯度方向，b值選取0、500s/mm2，行矢狀位掃描，并根據(jù)常規(guī)T2WI矢狀面進(jìn)行定位，即決定被分析的層面；分別測(cè)量急性脊髓損傷患者受損區(qū)域及受損區(qū)域水平以上區(qū)域的FA值和ADC值，分別比較兩者的差異，然后進(jìn)行統(tǒng)計(jì)學(xué)分析。利用DTT脊髓重建技術(shù)對(duì)受損的頸髓纖維束重建，進(jìn)行觀察。SWI序列采用橫軸位掃描，觀察受損頸髓的受損區(qū)域是否有異常低信號(hào)，并與常規(guī)MR掃描序列對(duì)比，評(píng)價(jià)其對(duì)出血灶的檢出率。 結(jié)果： 磁共振常規(guī)MR序列、SWI及DTI序列對(duì)受損頸髓進(jìn)行掃描后，在DTI掃描序列上，其相應(yīng)頸髓損傷節(jié)段的FA值、ADC值與其相對(duì)應(yīng)的頸髓受損區(qū)以上正常區(qū)域的FA值和ADC值比較均有明顯降低，進(jìn)行統(tǒng)計(jì)學(xué)分析，其差異有意義。部分在常規(guī)MR序列上陰性的患者，在DTI掃描后可見異常信號(hào)，，并且其所測(cè)得FA值和ADC值均有降低，證明DTI序列對(duì)頸髓損傷的情況較常規(guī)MR序列更敏感、更客觀。 利用DTT進(jìn)行頸髓重建，觀察受損頸髓纖維束走形及其完整性，觀察其纖維束有無扭曲、受壓、截?cái)嗟雀淖儭?在SWI掃描序列上，7例患者在常規(guī)MRI序列上未顯示異常高信號(hào)區(qū)，其相應(yīng)頸髓節(jié)段在SWI上可見小點(diǎn)狀、小斑片狀低信號(hào)；8例患者在常規(guī)MRI序列及SWI上均顯示異常信號(hào)；3例患者在常規(guī)MRI序列及SWI上均未見異常信號(hào)出現(xiàn)。經(jīng)統(tǒng)計(jì)學(xué)分析，兩者對(duì)受損頸髓出血灶的檢出率方面，統(tǒng)計(jì)學(xué)差異有意義。 結(jié)論： 1. DTI掃描能證明，急性頸髓損傷患者的頸髓受損區(qū)域的FA值和ADC值均有明顯下降，可對(duì)急性頸髓損傷患者做出客觀的定性、定量的評(píng)估。 2. DTT可直觀顯示頸髓纖維束的完整性和受損情況。 3. SWI較常規(guī)MR序列發(fā)現(xiàn)頸髓損傷后出血灶敏感。
[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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R651.2;R445.2
【參考文獻(xiàn)】
相關(guān)期刊論文 前9條
1 王葵光,陳曉亮,胡有谷;無骨折脫位型頸髓損傷的診治[J];青島大學(xué)醫(yī)學(xué)院學(xué)報(bào);2003年01期
2 劉昌盛;g品
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