脊柱侧弯畸形VISTA序列MRI评价研究

目的探讨MR各向同性T2加权容秘成像（VISTA序列）评价脊拄侧弯畸形的意义。材料与方法应用1．5T超导MR成像系统和相控阵全脊柱线圈，30例脊柱侧弯畸形患者行全脊柱常规MR扫描及分段VISTA扫捕，VISTA各段原始图像经无缝拼接后作曲面重组（cMPR）H像后处理，在单一平面上显示全脊柱及椎管内脊髓全貌。图像的诊断信息质量，按由劣至优顺序分为I、Ⅱ、Ⅲ级。结果VISTA．cMPR在单一平面上完整冠示扭曲脊柱及脊髓的全貌．30例脊柱侧弯畸形的诊断信息质量均评为Ⅲ级，其中全脊柱“S”形侧弯畸形23例，颈、胸段侧弯畸形3例，胸、腰段侧弯畸形3例，腰段侧弯畸形1例。30例中，伴发半椎体畸形3例，Chiari畸形4例，脊髓空洞症8例，脊髓低位拴系3例，脊髓血管坶细胞瘤、星彤细胞瘤各1例。常规MRI上诊断信息质量评价各级例数分别为I级26例、Ⅱ级3例、Ⅲ级1例.常规MRI与VISTA—cMPR两种诊断方法的独立性检验差异艟著性具有统计学意义（x2=28．06，P〈0．01）.结论MR—V1STA对于脊柱侧弯畸形的诊断和术前评估具有十分重要的意义。

VISTA-sequence magnetic resonance imaging evaluation of scoliosis

Objective： To assess the value of MR volumetric isotropic T2-weighted acquisition （VISTA） in evaluating scoliosis. Materials and Methods： VISTA images were obtained from 30 patients with scoliosis using a 1.5 T superconduct scanner and phase-array whole-spine coil. The segmentedly acquired source data of the spine were postprocessed to create the panoramic images with curved mu[ti-planar reconstruction （cMPR） after seamless splicing. An overall perspective of the spine and spinal cord was showed in the panoramic images, which were scored as grade I, grade II, or grade lIl based on the provided diagnostic information quality （DIQ）. Results： The DIQ was graded Ⅲ in all the 30 patients based on the VISTA-cMPR images. The perspective of the whole spine and spinal cord was visualized in the all the 30 cases, 23 of which were ＂S＂shaped scoliosis of the whole spine, 3 of cervicothoracic scoliosis, 3 of thoraco-lumbar scoliosis, and I of lumbar scoliosis with segment. Of the 30 cases, hemivertebrae deformity was identified in 3, Chiari malformation in 4, syringomyelia in 8, tethered syndrome in 3, and hemangioblastoma and astrocytoma in cervico- thoracic cord in 1, respectively. The panoramic findings of the scoliosis on both vertebral and spinal cord anomalies were surgically proved. The DIQ grading among the 30 patients was I in 26, Ⅱ in 3, and Ⅲ in 1, respectively, based on the conventional MRI . The difference of independent test between conventional MRI and VISTA- cMPR was statistically significant （x2=28.06, P〈0.01）. Conclusion： MR-VISTA plays a vital role in both the diagnosis and pre-surgical evaluation of scoliosis.