3D SPACE序列及后处理在显示大脑中动脉硬化中的临床价值

目的:探讨高分辨率MRI脑血管壁成像3D SPACE序列及后处理技术在显示大脑中动脉硬化中的价值。方法:对行MRI常规序列和3D SPACE序列检查、符合脑动脉硬化诊断标准的40例患者进行观察和分析。采用3D SPACE序列行冠状面T1WI-FS、T2WI-FS和T1WI-FS增强扫描、曲面重建(CPR),在CPR图像上行大脑中动脉的硬化斑块断面重建。分析动脉硬化斑块的以下MRI表现:病变数目、狭窄长度、断面血管形态、信号强度、强化程度、内膜的完整性。计算血管狭窄程度和测量增强的信号值。根据T2WI、DWI等表现等将患者分为急性脑梗死组(组1)、非急性脑梗死组(组2)和无脑梗死组(组3),比较各组病变MRI表现的差异。结果:40例患者CPR显示共61处位于大脑中动脉的硬化性病变。MRI表现为节段性或局限性狭窄,多为偏心性管壁增厚,T1WI和T2WI呈高、稍高或等信号,强化程度主要为明显、中度,血管内膜多不完整。急性脑梗死组(组1)19例,非急性脑梗死组(组2)11例,无脑梗死组(组3)10例。组1狭窄长度、T1WI-FS和T2WI-FS的信号强度、强化程度均高于组2和组3,组2、组3依次降低。急性脑梗死组的管腔狭窄程度为0.729±0.209,明显高于组2和组3(分别为0.482±0.232和0.406±0.194),差异有统计学意义(P<0.05)。3组增强的信号值分别为408.83±137.56、306.65±114.05、201.24±42.31,差异有统计学意义(P<0.05)。结论:3D SPACE序列及后处理技术显示大脑中动脉及其管壁硬化性病变具有一定优势,能显示动脉硬化斑块的多种MRI表现,且急性脑梗死、非急性脑梗死和无脑梗死患者各种MRI表现的严重程度也不相同,3D SPACE序列对大脑中动脉硬化性病变的显示具有一定价值。

The clinical values of 3D SPACE sequence and post-processing in displaying middle cerebral arterial sclerosis

Objectives:To investigate the values of 3D SPACE sequence of high-resolution magnetic resonance imaging of intracranial vessel and post-processing in displaying middle cerebral arterial sclerosis.Methods:Forty patients who were accord with diagnosing standard for atherosclerosis underwent routine MRI and 3D SPACE scanning.3D SPACE sequence was applied to the T1WI-FS,T2WI-FS,enhancement scanning and curve planar reconstruction(CPR)on the coronal plane of middle cerebral artery,and vessel transverse imaging through atherosclerotic plaques were reconstructed on CPR.The following MRI manifestations of atherosclerotic plaques were analyzed:number of lesions,length of stenosis,vascular morphology on transverse section,signal intensity,enhancing degree,plaque surface irregularity.The stenosis degree of vessel lumen was calculated and signal values of contrast enhancement were measured.The patients were divided in to acute cerebral infarction group(group 1),non-acute cerebral infarction group(group 2),non cerebral infarction group(group 3)according to T2WI and DWI images,and the difference of MRI manifestations among 3 groups were statistically analyzed.Results:Among 40 patients,CPR showed 61 arteriosclerotic lesions of middle cerebral artery of which the MRI manifestations showed segmental or focal stenosis,eccentric vessel wall thickening,hyperintensity or slightly hyperintensity or isointensity of lesions in T1WI-FS and T2WI-FS,intense or moderate enhancement of lesions,and most of tunica intima was incomplete.There were 19,11,and 10 patients respectively in group 1,2,and 3.The number of segment stenosis,length of stenosis,signal intensity,enhancing degree were higher in group 1 than those in group 2 and group 3,and the MRI manifestations mentioned above in group 2 and group 3 were lighten in turn.The stenosis degree of vessel lumen in group 1 were 0.729±0.209(percent),which was higher than that in other 2 groups(0.482±0.232,0.406±0.194,respectively;P<0.05).The signal values of plaques in post-contrast among 3 groups were 408.83±137.56,306.65±114.05,201.24±42.31 respectively(P<0.05).Conclusions:3D SPACE sequence and post-processing technology have certain superiority in displaying middle cerebral artery and its atherosclerotic lesions,and showing various MRI characteristic of the atherosclerotic plaques.The MRI manifestations vary in the degree of severity in acute cerebral infarction,non-acute cerebral infarction and non cerebral infarction that indicated 3D SPACE sequence had some clinical values for displaying atherosclerotic disease of middle cerebral artery.