CAJ | 학술논문

目的：探讨MR各向同性T2加权容积成像(VISTA序列)评价脊柱侧弯畸形的意义。材料与方法应用1.5 T超导MR成像系统和相控阵全脊柱线圈，30例脊柱侧弯畸形患者行全脊柱常规MR扫描及分段VISTA扫描，VISTA各段原始图像经无缝拼接后作曲面重组(cMPR)图像后处理，在单一平面上显示全脊柱及椎管内脊髓全貌。图像的诊断信息质量，按由劣至优顺序分为Ⅰ、Ⅱ、Ⅲ级。结果 VISTA-cMPR在单一平面上完整显示扭曲脊柱及脊髓的全貌，30例脊柱侧弯畸形的诊断信息质量均评为Ⅲ级，其中全脊柱“S”形侧弯畸形23例，颈、胸段侧弯畸形3例，胸、腰段侧弯畸形3例，腰段侧弯畸形1例。30例中，伴发半椎体畸形3例，Chiari畸形4例，脊髓空洞症8例，脊髓低位拴系3例，脊髓血管母细胞瘤、星形细胞瘤各1例。常规MRI上诊断信息质量评价各级例数分别为Ⅰ级26例、Ⅱ级3例、Ⅲ级1例。常规MRI与VISTA-cMPR两种诊断方法的独立性检验差异显著性具有统计学意义(χ2=28.06，P<0.01)。结论 MR-VISTA对于脊柱侧弯畸形的诊断和术前评估具有十分重要的意义。
목적：탐토MR각향동성T2가권용적성상(VISTA서렬)평개척주측만기형적의의。재료여방법응용1.5 T초도MR성상계통화상공진전척주선권，30례척주측만기형환자행전척주상규MR소묘급분단VISTA소묘，VISTA각단원시도상경무봉병접후작곡면중조(cMPR)도상후처리，재단일평면상현시전척주급추관내척수전모。도상적진단신식질량，안유렬지우순서분위Ⅰ、Ⅱ、Ⅲ급。결과 VISTA-cMPR재단일평면상완정현시뉴곡척주급척수적전모，30례척주측만기형적진단신식질량균평위Ⅲ급，기중전척주“S”형측만기형23례，경、흉단측만기형3례，흉、요단측만기형3례，요단측만기형1례。30례중，반발반추체기형3례，Chiari기형4례，척수공동증8례，척수저위전계3례，척수혈관모세포류、성형세포류각1례。상규MRI상진단신식질량평개각급례수분별위Ⅰ급26례、Ⅱ급3례、Ⅲ급1례。상규MRI여VISTA-cMPR량충진단방법적독립성검험차이현저성구유통계학의의(χ2=28.06，P<0.01)。결론 MR-VISTA대우척주측만기형적진단화술전평고구유십분중요적의의。
Objective:To assess the value of MR volumetric isotropic T2-weighted acquisition (VISTA) in evaluating scoliosis. Materials and Methods:VISTA images were obtained from 30 patients with scoliosis using a 1.5 T superconduct scanner and phase-array whole-spine coil. The segmentedly acquired source data of the spine were postprocessed to create the panoramic images with curved multi-planar reconstruction (cMPR) after seamless splicing. An overall perspective of the spine and spinal cord was showed in the panoramic images, which were scored as grade I, grade II, or grade III based on the provided diagnostic information quality (DIQ). Results:The DIQ was graded III in all the 30 patients based on the VISTA-cMPR images. The perspective of the whole spine and spinal cord was visualized in the all the 30 cases, 23 of which were “S”shaped scoliosis of the whole spine, 3 of cervicothoracic scoliosis, 3 of thoraco-lumbar scoliosis, and 1 of lumbar scoliosis with segment. Of the 30 cases, hemivertebrae deformity was identiifed in 3, Chiari malformation in 4, syringomyelia in 8, tethered syndrome in 3, and hemangioblastoma and astrocytoma in cervico-thoracic cord in 1, respectively. The panoramic findings of the scoliosis on both vertebral and spinal cord anomalies were surgically proved. The DIQ grading among the 30 patients was I in 26, II in 3, and III in 1, respectively, based on the conventional MRI . The difference of independent test between conventional MRI and VISTA-cMPR was statistically signiifcant (χ2=28.06, P<0.01). Conclusion:MR-VISTA plays a vital role in both the diagnosis and pre-surgical evaluation of scoliosis.