中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2013年
2期
127-131
,共5页
宋琼%曾蒙苏%陈财忠%马静%恽虹%饶圣样%姚秀忠
宋瓊%曾矇囌%陳財忠%馬靜%惲虹%饒聖樣%姚秀忠
송경%증몽소%진재충%마정%운홍%요골양%요수충
门静脉%磁共振成像%肝硬化
門靜脈%磁共振成像%肝硬化
문정맥%자공진성상%간경화
Portal vein%Magnetic resonance imaging%Liver cirrhosis
目的 通过与常规增强MRA技术容积式内插法屏气检查(VIBE)序列比较,评价非增强MRA技术可变反转角优化对比成像(SPACE)序列的图像质量,以及对肝硬化门静脉高压伴门静脉侧支形成的诊断价值.方法 选取2011年5-7月行门静脉MRA的连续就诊的30例患者,先行SPACE序列检查,然后再行VIBE序列成像,2名医师根据2种成像技术的原始图像及重组图像进行影像诊断,比较两者的影像诊断结果；对2种成像技术显示的门静脉主干及左右分支的信噪比(SNR)、对比噪声比(CNR)进行量化评估；并对2种成像技术所获图像整体质量及门静脉血管各级分支显示情况评分进行比较.2种成像方法间SNR和CNR的比较采用配对t检验,图像质量评分比较采用秩和检验.结果 30例患者中,诊断门静脉高压21例次、门静脉癌栓1例次、食管静脉曲张5例次、胃底静脉曲张11例次、脾门静脉曲张5例次、附脐静脉曲张5例次及门静脉海绵样变2例,2种成像技术诊断结果高度一致.SPACE序列图像门静脉主干、门静脉左支、门静脉右支的SNR分别为291 ±57、301 ±74、344±76,CNR分别为231±59、242±73、286±76,VIBE序列图像相应部位的SNR分别为185±56、176±52、182±52,CNR分别为57±23、50±21、57±19,SPACE序列SNR、CNR均高于VIBE序列,差异有统计学意义(t值分别为7.691、7.418、7.946、15.746、13.508、13.880,P值均＜0.01).图像整体质量及门静脉主干、左右支的评分差异无统计学意义(Z值分别为-1.496、-1.895、-1.496、-2.138、-2.324、-1.328,P值均＞0.05),但是门静脉左、右段级分支的质量评分,SPACE序列[(2.08±0.78)、(2.08±0.78)分]明显高于VIBE序列[(1.75±0.53)、(1.71±0.55)分],差异有统计学意义(Z值分别为-2.138、-2.324,P值均＜0.05).结论 SPACE序列图像在显示门静脉远端分支方面较增强MRA更为清晰,可用于对门静脉病变的影像诊断,对于肾功能不佳的患者可作为替代手段进行成像.
目的 通過與常規增彊MRA技術容積式內插法屏氣檢查(VIBE)序列比較,評價非增彊MRA技術可變反轉角優化對比成像(SPACE)序列的圖像質量,以及對肝硬化門靜脈高壓伴門靜脈側支形成的診斷價值.方法 選取2011年5-7月行門靜脈MRA的連續就診的30例患者,先行SPACE序列檢查,然後再行VIBE序列成像,2名醫師根據2種成像技術的原始圖像及重組圖像進行影像診斷,比較兩者的影像診斷結果；對2種成像技術顯示的門靜脈主榦及左右分支的信譟比(SNR)、對比譟聲比(CNR)進行量化評估；併對2種成像技術所穫圖像整體質量及門靜脈血管各級分支顯示情況評分進行比較.2種成像方法間SNR和CNR的比較採用配對t檢驗,圖像質量評分比較採用秩和檢驗.結果 30例患者中,診斷門靜脈高壓21例次、門靜脈癌栓1例次、食管靜脈麯張5例次、胃底靜脈麯張11例次、脾門靜脈麯張5例次、附臍靜脈麯張5例次及門靜脈海綿樣變2例,2種成像技術診斷結果高度一緻.SPACE序列圖像門靜脈主榦、門靜脈左支、門靜脈右支的SNR分彆為291 ±57、301 ±74、344±76,CNR分彆為231±59、242±73、286±76,VIBE序列圖像相應部位的SNR分彆為185±56、176±52、182±52,CNR分彆為57±23、50±21、57±19,SPACE序列SNR、CNR均高于VIBE序列,差異有統計學意義(t值分彆為7.691、7.418、7.946、15.746、13.508、13.880,P值均＜0.01).圖像整體質量及門靜脈主榦、左右支的評分差異無統計學意義(Z值分彆為-1.496、-1.895、-1.496、-2.138、-2.324、-1.328,P值均＞0.05),但是門靜脈左、右段級分支的質量評分,SPACE序列[(2.08±0.78)、(2.08±0.78)分]明顯高于VIBE序列[(1.75±0.53)、(1.71±0.55)分],差異有統計學意義(Z值分彆為-2.138、-2.324,P值均＜0.05).結論 SPACE序列圖像在顯示門靜脈遠耑分支方麵較增彊MRA更為清晰,可用于對門靜脈病變的影像診斷,對于腎功能不佳的患者可作為替代手段進行成像.
목적 통과여상규증강MRA기술용적식내삽법병기검사(VIBE)서렬비교,평개비증강MRA기술가변반전각우화대비성상(SPACE)서렬적도상질량,이급대간경화문정맥고압반문정맥측지형성적진단개치.방법 선취2011년5-7월행문정맥MRA적련속취진적30례환자,선행SPACE서렬검사,연후재행VIBE서렬성상,2명의사근거2충성상기술적원시도상급중조도상진행영상진단,비교량자적영상진단결과；대2충성상기술현시적문정맥주간급좌우분지적신조비(SNR)、대비조성비(CNR)진행양화평고；병대2충성상기술소획도상정체질량급문정맥혈관각급분지현시정황평분진행비교.2충성상방법간SNR화CNR적비교채용배대t검험,도상질량평분비교채용질화검험.결과 30례환자중,진단문정맥고압21례차、문정맥암전1례차、식관정맥곡장5례차、위저정맥곡장11례차、비문정맥곡장5례차、부제정맥곡장5례차급문정맥해면양변2례,2충성상기술진단결과고도일치.SPACE서렬도상문정맥주간、문정맥좌지、문정맥우지적SNR분별위291 ±57、301 ±74、344±76,CNR분별위231±59、242±73、286±76,VIBE서렬도상상응부위적SNR분별위185±56、176±52、182±52,CNR분별위57±23、50±21、57±19,SPACE서렬SNR、CNR균고우VIBE서렬,차이유통계학의의(t치분별위7.691、7.418、7.946、15.746、13.508、13.880,P치균＜0.01).도상정체질량급문정맥주간、좌우지적평분차이무통계학의의(Z치분별위-1.496、-1.895、-1.496、-2.138、-2.324、-1.328,P치균＞0.05),단시문정맥좌、우단급분지적질량평분,SPACE서렬[(2.08±0.78)、(2.08±0.78)분]명현고우VIBE서렬[(1.75±0.53)、(1.71±0.55)분],차이유통계학의의(Z치분별위-2.138、-2.324,P치균＜0.05).결론 SPACE서렬도상재현시문정맥원단분지방면교증강MRA경위청석,가용우대문정맥병변적영상진단,대우신공능불가적환자가작위체대수단진행성상.
Objective To evaluate the imaging quality of the non-contrast enhanced MR angiography of sampling perfection with application optimized contrasts using different flip angle evolutions (SPACE)in showing portal system and compared it with that of the contrast enhanced MR angiography of volumetric interpolated breath-hold examination (VIBE),and study its diagnostic ability in the detection of portosystemic and portohepatic collaterals.Methods Thirty consecutively cirrhotic patients with suspected of portosystemic and portohepatic collaterals were enrolled,and underwent SPACE followed by VIBE at 1.5 T MR scanner.The diagnostic accuracy of SPACE for the portal vein disease was evaluated by two doctors and compared it with that of VIBE.The contrast-to-noise ratio(CNR) and signal-to-noise ratio(SNR) of two MRA techniques were compared by using the Wilcoxon signed rank test.The quality assessment including scores of the portal vein segments and overall image quality were used the paired t test.Results Twenty-one patients were diagnosed as portal hypertension,including five types of portosystemic collaterals: esophageal varices (n =5),gastric fundic varices (n =11),splenic varices (n =5),paraumbilical varices (n =5) and cavemous transformation (n =2),and one patient was diagnosed as portal vein tumor thrombus.The diagnostic efficiency of SPACE was equivalent to that of VIBE.In SPACE,the SNR were 291 ± 57,301 ± 74,344 ±76 and the CNR were 231 ±59,242 ±73,286 ±76 at main portal vein,the left branch of portal vein and the right branch of portal vein,respectively.However in VIBE,the SNR were 185 ± 56,176 ± 52,182 ±52 and the CNR were 57 ±23,50 ±21,57± 19 at,respectively.Both SNR and CNR of portal vein segments in the former were better than those in the latter (t values were 7.691,7.418,7.946,15.746,13.508 and 13.880,respectively,P ＜ 0.05).There were no significant difference for the scores of displaying main,left branch and right branch portal vein and overall image quality in VIBE and SPACE (Z values were -1.496,-1.895,-1.496,-2.138,-2.324 and-1.328,respectively,P ＞ 0.05).The scores of displaying the distal branches of left and right portal vein were 2.08 ± 0.78,2.08 ± 0.78 in SPACE,and 1.75 ± 0.53,1.71 ± 0.55 in VIBE,respectively.It was better (Z =-2.138,-2.324,P ＜ 0.05) in SPACE than that in VIBE.Conclusion The SPACE has better visualization of portal vein distal branches than VIBE,and it can be applied for the diagnosis of the portal vein disease.
