糖尿病足磁共振增强成像优化方案的探讨

目的探讨糖尿病足磁共振增强成像的优化方案。方法纳入20例糖尿病足患者,对患足进行增强后的三维小角度激发快速梯度回波血管成像序列(3DFLASH-MRA)、三维容积内插法屏气序列(3DVIBE)-水激励(WE)、T1WI二维自旋回波(2DSE)-压脂(FS)、T1WI二维快速自旋回波(2DTSE)-FS、T1 WI二维小角度激发快速梯度回波(2DFLASH)-FS序列的扫描,比较各序列在足部血管显示,静脉重叠,关节软骨显示,足底皮肤、跟骨、趾短屈肌、足背动脉、距跟关节软骨的信噪比(SNR)及对比率(CR)的差异。结果①在足部血管显示及静脉重叠评价方面,3DFLASH-MRA优于其余序列(P<0.05);②在对关节软骨的显示方面,3DVIBE-WE序列优于2DSE-FS、2DTSE-FS、2DFLASH-FS(P<0.05);③足底皮肤、跟骨、趾短屈肌、足背动脉、距跟关节软骨的CR及足底皮肤、足背动脉、距跟关节软骨的SNR在3D VIBE-WE序列上高于其余序列(P<0.05)。结论 3DVIBE-WE序列应作为糖尿病足增强T1WI序列的首选序列,并在足部血管显示方面能作为3DFLASH-MRA的补充序列。

Optimal Protocol of MR Contrast Imaging in Diabetic Foot

Objective To identify the optimal protocol of MR contrast imaging in diabetic foot.Methods 20 patients with diabetic feet were enrolled and examined with 3D FLASH-MRA,3D VIBE-WE,2D SE-FS,2D TSE-FS and 2D FLASH-FS at a 1.5T MR scanner for vascular changes in feet.Their effectiveness in displaying blood vessels,venous aliasing and articular cartilage,as well as the signal-to-noise ratio(SNR) and contrast ratio(CR) of plantar skins calcaneus,flexor digitorum brevis,dorsal artery,and talocalcaneal joint cartilage in diabetic feet were compared.Results ① 3D FLASH-MRA was better in displaying blood vessels and venous aliasing than the others(P<0.05);② 3D VIBE-WE was better in displaying articular cartilage than 2D SE-FS,2D TSE-FS and 2D FLASH-FS(P<0.05);③ 3D VIBE-WE had higher SNR and CR of plantar skins,dorsal artery,talocalcaneal joint cartilage,calcaneus,and flexor digitorum brevis than the others(P<0.05).Conclusion 3D VIBE-WE is the preferred sequence for T1 weighted imaging with contrast in diabetic feet.It can also serve as the supplemental sequence of 3D FLASH-MRA in MR angiography.