CAJ | 학술논문

目的：探讨采用小线圈和三维稳态自由进动快速成像脂肪抑制（3D-FISP-FS）序列显示腮腺段面神经及腮腺导管的价值。方法前瞻性收集18名腮腺常规MRI平扫未发现异常的健康志愿者纳入研究。受试者分别采用头颈线圈（36侧）、4 cm环形小线圈（32侧）行腮腺3D-FISP-FS序列扫描。对所获得的图像行MPR、MIP及CPR重组，并观察腮腺区结构的MRI信号特征、对图像质量进行主观评分、测量计算面神经信号强度比（SIRN）和腮腺导管信号强度比（SIRD）、观察面神经及腮腺导管的显示。头颈线圈、小线圈3D-FISP-FS序列图像的评分采用配对资料的符号秩和检验比较，2组图像的SIRN、SIRD采用配对资料t检验比较，2组图像上对面神经及腮腺导管的显示采用χ2检验比较。结果18名志愿者均顺利完成腮腺MRI扫描。3D-FISP-FS图像上，腮腺实质为稍低信号，肌肉组织呈中等信号，血管呈等、稍高或高信号，面神经腮腺段呈线样高信号影弯曲走行，腮腺导管呈弧形高信号，淋巴结呈肾形、类椭圆形或梭形高信号影。采用头颈线圈和小线圈图像的主观评分分别为（2.0±0.9）、（1.5±0.7）分，差异有统计学意义（Z=－2.714，P=0.007），小线圈组图像质量优于头颈线圈组。头颈线圈和小线圈图像的SIRN分别为1.7±0.8、2.1±1.2，SIRD分别为1.8±0.7、2.5±1.7，差异组间比较均有统计学意义（t值分别为2.978、2.427，P值分别为0.006、0.031）。采用头颈线圈和小线圈均可显示全部面神经主干。头颈线圈图像上可显示面神经腮腺段一级分支颞面干25侧、颈面干15侧，面神经腮腺段二级分支颞面干分支17侧、颈面干分支11侧，腮腺导管16侧；小线圈图像上可显示面神经腮腺段一级分支颞面干30侧、颈面干28侧，面神经腮腺段二级分支颞面干分支26侧、颈面干分支23侧，腮腺导管27侧。两种线圈图像显示面神经一、二级分支和腮腺导管的差异均有统计学意义（P均<0.05）。结论3D-FISP-FS序列腮腺区成像可同时显示腮腺段面神经及腮腺导管，成像效果小线圈优于头颈线圈。目的：探討採用小線圈和三維穩態自由進動快速成像脂肪抑製（3D-FISP-FS）序列顯示腮腺段麵神經及腮腺導管的價值。方法前瞻性收集18名腮腺常規MRI平掃未髮現異常的健康誌願者納入研究。受試者分彆採用頭頸線圈（36側）、4 cm環形小線圈（32側）行腮腺3D-FISP-FS序列掃描。對所穫得的圖像行MPR、MIP及CPR重組，併觀察腮腺區結構的MRI信號特徵、對圖像質量進行主觀評分、測量計算麵神經信號彊度比（SIRN）和腮腺導管信號彊度比（SIRD）、觀察麵神經及腮腺導管的顯示。頭頸線圈、小線圈3D-FISP-FS序列圖像的評分採用配對資料的符號秩和檢驗比較，2組圖像的SIRN、SIRD採用配對資料t檢驗比較，2組圖像上對麵神經及腮腺導管的顯示採用χ2檢驗比較。結果18名誌願者均順利完成腮腺MRI掃描。3D-FISP-FS圖像上，腮腺實質為稍低信號，肌肉組織呈中等信號，血管呈等、稍高或高信號，麵神經腮腺段呈線樣高信號影彎麯走行，腮腺導管呈弧形高信號，淋巴結呈腎形、類橢圓形或梭形高信號影。採用頭頸線圈和小線圈圖像的主觀評分分彆為（2.0±0.9）、（1.5±0.7）分，差異有統計學意義（Z=－2.714，P=0.007），小線圈組圖像質量優于頭頸線圈組。頭頸線圈和小線圈圖像的SIRN分彆為1.7±0.8、2.1±1.2，SIRD分彆為1.8±0.7、2.5±1.7，差異組間比較均有統計學意義（t值分彆為2.978、2.427，P值分彆為0.006、0.031）。採用頭頸線圈和小線圈均可顯示全部麵神經主榦。頭頸線圈圖像上可顯示麵神經腮腺段一級分支顳麵榦25側、頸麵榦15側，麵神經腮腺段二級分支顳麵榦分支17側、頸麵榦分支11側，腮腺導管16側；小線圈圖像上可顯示麵神經腮腺段一級分支顳麵榦30側、頸麵榦28側，麵神經腮腺段二級分支顳麵榦分支26側、頸麵榦分支23側，腮腺導管27側。兩種線圈圖像顯示麵神經一、二級分支和腮腺導管的差異均有統計學意義（P均<0.05）。結論3D-FISP-FS序列腮腺區成像可同時顯示腮腺段麵神經及腮腺導管，成像效果小線圈優于頭頸線圈。
목적：탐토채용소선권화삼유은태자유진동쾌속성상지방억제（3D-FISP-FS）서렬현시시선단면신경급시선도관적개치。방법전첨성수집18명시선상규MRI평소미발현이상적건강지원자납입연구。수시자분별채용두경선권（36측）、4 cm배형소선권（32측）행시선3D-FISP-FS서렬소묘。대소획득적도상행MPR、MIP급CPR중조，병관찰시선구결구적MRI신호특정、대도상질량진행주관평분、측량계산면신경신호강도비（SIRN）화시선도관신호강도비（SIRD）、관찰면신경급시선도관적현시。두경선권、소선권3D-FISP-FS서렬도상적평분채용배대자료적부호질화검험비교，2조도상적SIRN、SIRD채용배대자료t검험비교，2조도상상대면신경급시선도관적현시채용χ2검험비교。결과18명지원자균순리완성시선MRI소묘。3D-FISP-FS도상상，시선실질위초저신호，기육조직정중등신호，혈관정등、초고혹고신호，면신경시선단정선양고신호영만곡주행，시선도관정호형고신호，림파결정신형、류타원형혹사형고신호영。채용두경선권화소선권도상적주관평분분별위（2.0±0.9）、（1.5±0.7）분，차이유통계학의의（Z=－2.714，P=0.007），소선권조도상질량우우두경선권조。두경선권화소선권도상적SIRN분별위1.7±0.8、2.1±1.2，SIRD분별위1.8±0.7、2.5±1.7，차이조간비교균유통계학의의（t치분별위2.978、2.427，P치분별위0.006、0.031）。채용두경선권화소선권균가현시전부면신경주간。두경선권도상상가현시면신경시선단일급분지섭면간25측、경면간15측，면신경시선단이급분지섭면간분지17측、경면간분지11측，시선도관16측；소선권도상상가현시면신경시선단일급분지섭면간30측、경면간28측，면신경시선단이급분지섭면간분지26측、경면간분지23측，시선도관27측。량충선권도상현시면신경일、이급분지화시선도관적차이균유통계학의의（P균<0.05）。결론3D-FISP-FS서렬시선구성상가동시현시시선단면신경급시선도관，성상효과소선권우우두경선권。
Objective To explore the value of small surface coil combine with three-dimensional fast imaging with steady state precession and fat-suppression (3D-FISP-FS) sequence in displaying intra-parotid facial nerves segment and parotid ducts.Methods The parotid regions of 18 healthy volunteers who were excluded any parotid diseases were scanned by head&neck coil (36 sides) and 4 cm small surface coil (32 sides) combined with 3D-FISP-FS sequence prospectively. The obtained original <br> images were treated through MIP, MPR and CPR, The MRI signal characteristics of parotid region structure, the subjective score of image quality, the signal intensity ratio (SIR) of facial nerve/parotid tissue (SIR N) and parotid duct/parotid tissue (SIRD) was calculated, and the displaying rates of the facial nerves and parotid ducts were observed. Wilcoxon matched-samples signed rank sum test was used to compare the scores of head&neck coil and small coil 3D-FISP-FS sequence images, paired t test was used to compare SIRN, SIRD of the two groups, Chi-square test was used to compare of the displaying rate of the facial nerves and parotid ducts in two groups. Results Eighteen volunteers were successfully performed MRI scan of parotid gland. On 3D-FISP-FS sequence images, the parotid gland was showed slightly low signal intensity, muscle tissue was showed medium signal intensity, the vessels were showed slightly high or high signal, parotid segment of facial nerve was showed tortuous line-like high signal intensity, and parotid duct was showed curve high signal intensity, lymph nodes were showed kidney shaped, oval or spindle shaped high signal intensity structures. The subjective scores for head and neck coil and coil images were (2.0 ± 0.9) and (1.5 ± 0.7) respectively, and the difference was statistically significant (Z=-2.714, P=0.007), image quality of small coil group was better than that of head and neck coil group. The SIRN of the two groups was 1.7±0.8 and 2.1± 1.2 respectively, and the SIRD was 1.8±0.7 and 2.5±1.7 respectively, which showed a statistically significant difference between the two groups (t value was 2.978, 2.427 respectively, P value was 0.006, 0.031 respectively).All facial nerve trunks could be displayed by head and neck coil and small coil. On head and neck coil images, 25 sides of temporofacial truck, 15 sides of cervicofacial truck, 17 sides of temporofacial branches, 11 sides of cervicofacial branches, 16 sides of the parotid duct could be displayed. On small coil images, 30 sides of temporofacial truck, 28 sides of cervicofacial truck, 26 sides of temporofacial branches, 23 sides of cervicofacial branches, 27 sides of the parotid duct could be displayed, which showed a statistically significant difference (P<0.05). Conclusion Small surface coil performed better in parotid MR imaging with 3D-FISP-FS sequence than that of head and neck coil, which can simultaneous clearly display the trunk and branches of the intra-parotid facial nerves and parotid ducts.