脊椎骨髓病变的MRI序列选择及诊断 价值

目的探讨脊椎骨髓病变的MRI最佳成像序列及诊断价值。方法应用T1FLAIR序列T1WI和FRFSE序列T2WI,结合STIR和脂肪抑制技术的T1WI增强,在1.5T的MRI机上对26例对照组和24例脊椎骨髓病变(观察组)行MRI成像,观察各种序列对病变显示的情况。将能特征性显示病变的MRI序列作为评价标准。结果T1WI显示病变的敏感性和特异性分别为100%(24/24)和92%(24/26),T2WI为54%(13/24)和88%(23/26),STIR为96%(23/24)和92%(22/24),增强为68%(13/19)和94%(15/16)。以上4种序列显示病变的准确性分别是96%(48/50)、72%(36/50)、94%(45/48)和80%(28/35)。结论T1WI、T2WI、STIR和MRI增强扫描在显示脊椎骨髓病变上都有较高的敏感性,T1WI是显示脊椎骨髓病变最敏感的序列,与T2WI或STIR和增强联合运用可以更有效地评价脊椎骨髓病变。

Value of MRI sequences selection and diagnosis in bone marrow leson of spine

Objective To study the best MRI sequences of bone marrow lesions of the spine and MRI value of diagnosis.Methods T1-weighted (2600/24/760msTR/TE/TI]), T2-weighted(7500/114ms), STIR(2500/20/160msTR/TE/TI]) and gadolinium-enhanced T1-weighted MRI images were obtained with a 1.5-T system in 24 patients with bone marrow lesions of the spine and 26 normal subjects. Conditions of various sequences on lesions were observed .MRI sequences which can show characteristically lesions should be taken as evaluation standard.Results The diagnostic sensitivity and specificity of T1-weighted imaging was 100%(24/24) and 92%(24/26),T2-weighted imaging was 54%(13/24) and 88%(23/26),STIR was 96%(23/24) and 92%(22/24), gadolinium-enhanced T1-weighted imaging was 68%(13/19) and 94%(15/16). The diagnostic accuracy of four sequences were 96%(48/50)?72%(36/50)?94%(45/48) and 80%(28/35) respectively.Conclusion T1-weighted, T2-weighted, STIR sequences and gadolinium-enhanced T1-weighted MRI images all provide a higher degree of sensitivity for detecting bone marrow abnormalities.T1-weighted MRI is the best sensitive sequence which show bone marrow abnormalities of the spine. The combination of T1-weighted and either T2-weighted or STIR images and gadolinium-enhanced T1-weighted MRI images is more effective to evaluate bone marrow lesions of spine.