CAJ | 학술논문

目的：比较单方向背景抑制扩散加权成像（ DWIBS）与三维短时反转恢复快速自旋回波成像（3D STIR SPACE）增强扫描2种方法显示臂丛神经的优势及不足。方法20名正常志愿者行臂丛神经单方向DWIBS与3D STIR SPACE增强扫描，原始图像经冠状面MIP重组，所得图像质量分别从臂丛神经各部分显示情况及背景抑制情况（ I～IV分评分法）2方面进行评价。双侧臂丛神经锁骨上部分（脊神经C5～T1）20名受试者双侧共计200支，锁骨下部分20名受试者双侧共计40支。2种成像方法对臂丛神经的显示情况进行配对资料χ2检验；对背景抑制情况评分结果采用非参数Wilcoxon符号秩和检验进行比较。结果单方向DWIBS与3D STIR SPACE增强扫描2种方法中，双侧臂丛神经锁骨上部分（C5～T1）、锁骨下部分的显示率分别是84％（167/200）、33％（13/40）与99％（198/200）、95％（38/40），2种方法间比较差异均具有统计学意义（χ2值分别为28.18、31.15，P值均＜0.01）；单方向DWIBS扫描背景抑制评分Ⅰ～Ⅳ分的分别为0、0、4、16名，3D STIR SPACE增强扫描背景抑制评分Ⅰ～Ⅳ分的分别为15、4、1、0名，2者间差异具有统计学意义（Z＝3.96，P＜0.01），3D STIR SPACE增强扫描背景抑制评分明显优于单方向DWIBS。结论3D STIR SPACE增强扫描较单方向DWIBS可获得更好的臂丛神经图像质量，能显示臂丛神经全部走行。
목적：비교단방향배경억제확산가권성상（ DWIBS）여삼유단시반전회복쾌속자선회파성상（3D STIR SPACE）증강소묘2충방법현시비총신경적우세급불족。방법20명정상지원자행비총신경단방향DWIBS여3D STIR SPACE증강소묘，원시도상경관상면MIP중조，소득도상질량분별종비총신경각부분현시정황급배경억제정황（ I～IV분평분법）2방면진행평개。쌍측비총신경쇄골상부분（척신경C5～T1）20명수시자쌍측공계200지，쇄골하부분20명수시자쌍측공계40지。2충성상방법대비총신경적현시정황진행배대자료χ2검험；대배경억제정황평분결과채용비삼수Wilcoxon부호질화검험진행비교。결과단방향DWIBS여3D STIR SPACE증강소묘2충방법중，쌍측비총신경쇄골상부분（C5～T1）、쇄골하부분적현시솔분별시84％（167/200）、33％（13/40）여99％（198/200）、95％（38/40），2충방법간비교차이균구유통계학의의（χ2치분별위28.18、31.15，P치균＜0.01）；단방향DWIBS소묘배경억제평분Ⅰ～Ⅳ분적분별위0、0、4、16명，3D STIR SPACE증강소묘배경억제평분Ⅰ～Ⅳ분적분별위15、4、1、0명，2자간차이구유통계학의의（Z＝3.96，P＜0.01），3D STIR SPACE증강소묘배경억제평분명현우우단방향DWIBS。결론3D STIR SPACE증강소묘교단방향DWIBS가획득경호적비총신경도상질량，능현시비총신경전부주행。
Objective To evaluate two different MRI techniques , enhanced 3D STIR SPACE and unidirectionally-encoded DWIBS MR Neurography in visualizing the brachial plexus.Methods Twenty healthy volunteers underwent MR scanning by the procedures of unidirectionally -encoded DWIBS and enhanced 3D STIR SPACE sequence of the brachial plexus.Original images were reconstructed with coronal maximum intensity projection ( MIP ).The image quality was assessed by comparing the visualization of various parts of the brachial plexus and the suppression ratio of image background.The degree of visualization was compared via χ2-test of paired data , and comparison of background suppression scores was performed using a nonparametric Wilcoxon signed rank sum test.Results The successful rate of visualizing the brachial plexus supraclavicular section ( C5-T1 ) was 84% ( 167/200 ) and 99% ( 198/200 ) , respectively, for the DWIBS and enhanced 3D STIR SPACE, and the rate for the infraclavicular section was 33%( 13/40 ) and 95% ( 38/40 ).The differences between these two techniques were statistically significant (χ2 value was 28.18 and 31.15 respectively, P <0.01).In all images, the scores of grade (Ⅰ-Ⅳ) of background suppression were 0, 0, 4 and 16 for unidirectionally-encoded DWIBS, respectively;while they were 15, 4, 1 and 0 for enhanced 3D STIR SPACE.There was significant difference between the two techniques ( Z =3.96,P <0.01).Conclusions High-quality MR neurography of the brachial plexus can be obtained using the enhanced 3D STIR SPACE sequence.It offers a complete anatomical coverage of the brachial plexus , and thus demonstrates a better capacity in depicting the anatomy of brachial plexus as compared with the unidirectionally-encoded DWIBS.