多发性骨髓瘤多种磁共振成像序列图像质量的比较

目的 比较磁共振T1WI脂相、T1WI水相、短时反转恢复(STIR)序列以及弥散加权成像(DWI)序列在评价多发性骨髓瘤(MM)时的图像质量。方法 对20例初诊或治疗后随诊的MM患者行冠状位T1WI脂相、T1WI水相、STIR序列及轴位DWI序列扫描,分段评价4个扫描序列的图像质量。测量并计算每个扫描序列的颅骨、脊柱、骨盆、肱骨、股骨、胫腓骨及肋骨处图像的信噪比(SNR)。选取20处MM的活动性病灶,测量并计算每个扫描序列病变部位的强化噪声比(CNR)。结果 所有图像质量均在可评价范围内。T1WI脂相、T1WI水相、STIR序列以及DWI序列的平均图像质量评分分别为4.19±0.70、4.16±0.73、3.89±0.70及3.76±0.68,T1WI脂相和水相的图像质量明显优于STIR序列(P=0.000和P=0.001)和DWI序列(P均=0.000),但T1WI脂相及水相之间(P=0.723)、STIR序列及DWI序列之间(P=0.167)差异均无统计学意义。T1WI水相的SNR显著高于T1WI脂相、STIR序列及DWI序列(P均=0.000),而后三者间差异无统计学意义(P均＞0.05)。DWI序列的CNR均值虽略高于其他3个序列,但4个扫描序列CNR之间差异均无统计学意义(P均＞0.05)。结论 T1WI脂相、T1WI水相、STIR序列及DWI序列成像各具优势,应联合应用诊断MM。

Comparison of the Quality of Different Magnetic Resonance Image Sequences of Multiple Myeloma

Objective To compare the image quality of T1WI fat phase,T1WI water phase,short time inversion recovery(STIR) sequence,and diffusion weighted imaging(DWI) sequence in the evaluation of multiple myeloma(MM). Methods Totally 20MM patients were enrolled in this study. All patients underwent scanning at coronal T1WI fat phase,coronal T1WI water phase,coronal STIR sequence,and axial DWI sequence. The image quality of the four different sequences was evaluated. The image was divided into seven sections(head and neck,chest,abdomen,pelvis,thigh,leg,and foot),and the signal-to-noise ratio(SNR)of each section was measured at 7 segments(skull,spine,pelvis,humerus,femur,tibia and fibula and ribs)were measured. In addition,20 active MM lesions were selected,and the contrast-to-noise ratio(CNR)of each scan sequence was calculated. Results The average image quality scores of T1WI fat phase,T1WI water phase,STIR sequence,and DWI sequence were 4.19±0.70,4.16±0.73,3.89±0.70,and 3.76±0.68,respectively. The image quality at T1-fat phase and T1-water phase were significantly higher than those at STIR(P=0.000 and P=0.001)and DWI sequence(both P=0.000);however,there was no significant difference between T1-fat and T1-water phase(P=0.723)and between STIR and DWI sequence(P=0.167). The SNR of T1WI fat phase was significantly higher than those of the other three sequences(all P=0.000),and there was no significant difference among the other three sequences(all P＞0.05). Although the CNR of DWI sequences was slightly higher than those of the other three sequences,there was no significant difference among all of them(all P>0.05). Conclusion Imaging at T1WI fat phase,T1WI water phase,STIR sequence,and DWI sequence has certain advantages,and they should be combined in the diagnosis of MM.