MR 3D-SPACE-STIR与3D-DESS序列显示锁骨上臂丛神经

目的 对比观察MR三维可变翻转角快速自旋回波(3D-SPACE)-短时反转恢复(STIR)与三维双回波稳态(3D-DESS)序列显示锁骨上臂丛神经的价值。方法 纳入41例疑诊臂丛神经损伤患者，均接受MR检查，其中11例臂丛神经损伤、30例未损伤，观察平扫和增强3D-SPACE-STIR及3D-DESS序列图像，比较4组图像显示神经效果、背景抑制评分及对比度噪声比(CNR)。结果 锁骨上臂丛神经于平扫3D-SPACE-STIR序列呈高低混杂信号，损伤后信号更高；于增强3D-SPACE-STIR序列呈高信号，损伤后信号更高；于平扫3D-DESS序列呈稍高信号，损伤后信号无明显变化。上述3组图像均可清晰显示神经连续性及其径线，其中增强3D-SPACE-STIR序列效果最佳。增强3D-DESS序列中，锁骨上臂丛神经呈等信号，与周围肌肉信号相仿；损伤后信号无明显变化。显示锁骨上臂丛神经评分由高到低依次为增强3D-SPACE-STIR、平扫3D-DESS、平扫3D-SPACE-STIR及增强3D-DESS序列(P均<0.05);背景抑制评分由高到低依次为增强3D-SPACE-STIR、平扫3...

MR 3D-SPACE-STIR and 3D-DESS sequences for displaying supraclavicular brachial plexus

Objective To compare the value of MR 3D sampling perfection with application optimized contrasts using different flip angle evolutions (3D-SPACE)-short-tau inversion recovery (STIR) and 3D double-echo steady state (3D-DESS) sequences for displaying supraclavicular brachial plexus. Methods Totally 41 patients with suspected brachial plexus injury who underwent MR examination were enrolled, including 11 cases with and 30 cases without brachial plexus injuries. Plain and enhanced 3D-SPACE-STIR and 3D-DESS sequence images were observed, and the neural display score, background suppression score and contrast-to-noise ratio (CNR) were compared among 4 groups of images. Results The uninjured supraclavicular brachial plexus presented as mixed signals on plain 3D-SPACE-STIR sequence, while the signals of injured ones were higher. The uninjured plexus presented as high signals on enhanced 3D-SPACE-STIR sequence, while the signals of injured ones were higher. The uninjured plexus presented as slightly higher signals on plain 3D-DESS sequence, and the signals of injured ones did not change significantly. All the above 3 groups of images could clearly show the continuity and thickness of supraclavicular brachial plexus, and the effect of the latter was the best. The uninjured supraclavicular brachial plexus presented as equal signals on enhanced 3D-DESS sequence, similar to the signals of surrounding muscles, while the signals of injured ones did not significantly change. The neural display scores from high to low were enhanced 3D-SPACE-STIR, plain 3D-DESS, plain 3D-SPACE-STIR and enhanced 3D-DESS sequence (all P<0.05). The background suppression score from high to low were enhanced 3D-SPACE-STIR, plain 3D-DESS and plain 3D-SPACE-STIR/enhanced 3D-DESS sequence (all P<0.05), while CNR based on uninjured supraclavicular brachial plexus from high to low were enhanced 3D-SPACE-STIR, plain 3D-SPACE-STIR, plain 3D-DESS and enhanced 3D-DESS sequence (all P<0.05). Conclusion Enhanced 3D-SPACE-STIR sequence could clearly display supraclavicular brachial plexus and inhibit the surrounding background signals. MRI signals of injuried supraclavicular brachial plexus changed obviously, being helpful for clinical diagnosis.