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Rs-EPI弥散加权成像在颅内占位性病变的临床应用研究

Clinical Study of Rs-EPI DWI to Improve Imaging Quality and Assessment on Intracranial Mass Lesions

  • 摘要: 目的与常规单次激发平面回波(Ss-EPI)弥散加权成像(DWI)比较,探讨读出方向分段采样平面回波(Rs-EPI)DWI序列在颅内占位性病变的临床应用价值。方法连续纳入临床诊断为颅内占位性病变的患者21例,采用SEIMENS Skyra 3.0T MRI及20通道的头颈联合线圈,行常规Ss-EPI DWI和Rs-EPI DWI序列扫描,由2名高年资影像诊断医师从对比噪声比(CNR)、信噪比(SNR)、伪影、图像整体质量及病变显示等方面进行评价分析。两种序列的图像质量比较采用非参数Wilcoxon符号秩和检验,2名阅片者之间一致性检测采用Kappa检验及组内相关系数(ICC)分析。结果21例患者均成功完成两组序列扫描。Ss-EPI DWI序列的SNR、CNR(130.46±49.10,33.22±18.86)高于Rs-EPI DWI序列(71.58±30.43,17.92±18.72)(P均<0.05)。鼻窦旁、乳突气房旁、额窦旁Rs-EPI DWI畸变伪影(3.67±0.48,3.57±0.50,3.90±0.30)小于Ss-EPI DWI(2.10±0.10,2.33±0.58,2.80±0.60)(P均<0.05);Rs-EPI DWI病变显示优于Ss-EPI DWI(3.95±0.22 vs. 3.19±0.60,P<0.05);Rs-EPI DWI图像整体质量优于Ss-EPI DWI(3.86±0.86 vs. 2.71±0.46,P<0.05)。Rs-EPI DWI图像变形小于Ss-EPI DWI(0.016±0.021 vs. 0.037±0.069,P=0.00)。2名阅片者对两种序列的主观及客观评价一致性好〔0.74≤Kappa值或ICC≤0.92〕。结论Rs-EPI DWI序列提高颅内占位性病变显示情况,降低了图像畸变伪影,可获得高分辨、高图像质量的弥散加权图像。

     

    Abstract: Objective To explore the clinical value of readout-segmented echo planar imaging (Rs-EPI) sequence in the assessment of intracranial mass lesions compared to the standard single-shot EPI (Ss-EPI) sequence. Methods We included 21 patients with intracranial mass lesions who underwent both Ss-EPI diffusion weighted imaging(DWI)and Rs-EPI DWI at 3.0T MR scanner with a twenty-channel head-neck coil. The quality of images was assessed by two experienced radiologists independently. The differences in image quality between two sequences were analyzed using Wilcoxon signed-rank test. Inter-observer agreements were analyzed using interclass correlation coefficient (ICC) and Kappa test. Results All objectives were completed on 3.0T MR. The signal-to-noise ratio(SNR) and contrast-to-noise ratio (CNR) in Rs-EPI DWI were higher than those in Ss-EPI DWI (130.46±49.10 vs. 71.58±30.43,P=0.000; 33.22±18.86 vs. 17.92±18.72,P=0.003). The scores of overall image quality, ghost artifact where next to the paranasal sinuses,mastoid air cells and frontal sinus of Rs-EPI DWI were significantly higher than those of Ss-EPI DWI. Meanwhile, the geometric distortion of anatomical structures of Rs-EPI DWI were significantly lower compared to Ss-EPI DWI sequence (0.016±0.021 vs. 0.037±0.069,P=0.00). The inter-reader and intra-reader agreements for the assessment of qualitative parameters were good 〔0.74≤Kappa value or ICC≤0.92〕.Conclusion Rs-EPI DWI sequence is a potential technique to improve the imaging quality in the diagnosis of intracranial mass lesions.

     

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