CAJ | 학술논문

目的：比较3.0 T磁共振3D-DESS与3D-SPACE在腰骶丛神经(sacral plexus，SP)成像中的临床应用价值。材料与方法(1)正常志愿者组：采用男女各5名健康志愿者行3D-DESS与3D-SPACE在骶丛神经根成像，选取L5神经评价影像图像，并采用2名医师采用5分法分别主观评价两序列图像质量，测量L5神经最大长度和L5神经节长径大小，采用配对t检验比较同一序列下左右侧SP是否存在差异，其次比较两序列是否存在差异。(2)病例组：前瞻性纳入98例SP占位患者，并利用两序列行SP成像；采用与志愿者相同方法分析病灶特征和正常神经解剖结构特征评价两序列的优劣并独立评分，采用Mann-Whitney U检验，比较两序列在显示SP病变特征差异，设定P＜0.05差异有统计学意义。结果10名志愿者年龄范围为20～27岁；3D-DESS序列与3D-SPACE序列在左右侧L5神经节大小配对t检验中均无统计学差异；3D-DESS能显示粗大的神经根，3D-SPACE对神经长度的显示优于3D-DESS，且具有统计学差异(t值分别为5.45和9.481， P=0.000)，但两序列比较双侧L5神经节的大小时无明显统计学差异(P=0.79， P=0.70)；98例患者18～74岁，平均(62.8±7.52)岁；3D-DESS与3D-SPACE对正常神经解剖评分中，3D-SPACE[(4.41±0.67)分]明显高于DESS[(3.75±0.75)分]，DESS显示神经根细节较好，差异具有统计学意义(P=0.036)；对于神经根病变的评价，DESS[(4.07±0.83)分]较SPACE[(3.57±0.65)分]高，且无统计学差异(P=0.099)。结论3D-SPACE与3D-DESS联合应用能清晰显示SP病灶细节，3D-DESS在神经泌尿学方面相对更实用、更准确。
목적：비교3.0 T자공진3D-DESS여3D-SPACE재요저총신경(sacral plexus，SP)성상중적림상응용개치。재료여방법(1)정상지원자조：채용남녀각5명건강지원자행3D-DESS여3D-SPACE재저총신경근성상，선취L5신경평개영상도상，병채용2명의사채용5분법분별주관평개량서렬도상질량，측량L5신경최대장도화L5신경절장경대소，채용배대t검험비교동일서렬하좌우측SP시부존재차이，기차비교량서렬시부존재차이。(2)병례조：전첨성납입98례SP점위환자，병이용량서렬행SP성상；채용여지원자상동방법분석병조특정화정상신경해부결구특정평개량서렬적우렬병독립평분，채용Mann-Whitney U검험，비교량서렬재현시SP병변특정차이，설정P＜0.05차이유통계학의의。결과10명지원자년령범위위20～27세；3D-DESS서렬여3D-SPACE서렬재좌우측L5신경절대소배대t검험중균무통계학차이；3D-DESS능현시조대적신경근，3D-SPACE대신경장도적현시우우3D-DESS，차구유통계학차이(t치분별위5.45화9.481， P=0.000)，단량서렬비교쌍측L5신경절적대소시무명현통계학차이(P=0.79， P=0.70)；98례환자18～74세，평균(62.8±7.52)세；3D-DESS여3D-SPACE대정상신경해부평분중，3D-SPACE[(4.41±0.67)분]명현고우DESS[(3.75±0.75)분]，DESS현시신경근세절교호，차이구유통계학의의(P=0.036)；대우신경근병변적평개，DESS[(4.07±0.83)분]교SPACE[(3.57±0.65)분]고，차무통계학차이(P=0.099)。결론3D-SPACE여3D-DESS연합응용능청석현시SP병조세절，3D-DESS재신경비뇨학방면상대경실용、경준학。
Objective:To compare three-dimensional double-echo steady state (3D-DESS) and three-dimensional perfection with application optimized contrasts using different flip angle evolutions (3D-SPACE) in the evaluation of sacral plexus (SP).Materials and Methods:Ten volunteers underwent 3D-DESS and 3D-SPACE using a 3.0 T MRI scanner. Ninety-eight consecutive patients with suspected SP disease underwent 3D-DESS and 3D-SPACE at a 3.0 T MRI. The scores and details SP in 3D-DESS and 3D-SPACE had been prospectively interpreted by 2 radiologists Standardized “Likert” scales from 1 to 5 were used to evaluate the imaging qualities; the length of L5 and size of L5 ganglions in 3D-DESS and 3D-SPACE were applied using comparativet-test to perform statistical analysis. Comparisons between normal and abnormal anatomy in SP were evaluated using the Mann-Whitney Utest.Results:3D-SPACE was signiifcantly superior to 3D-DESS (t=9.481,t=5.45,P=0.000) in the evaluation of SP nerve ifbers. There was no signiifcance in L5 ganglions size (P=0.79,P=0.70 respectively) between 3D-DESS and 3D-SPAC; 3D-SPACE (4.41±0.67) was signiifcantly superior to 3D-DESS (3.75±0.75) in normal anatomy structures (U=38, P=0.036). 3D-DESS (4.07±0.83) was superior to 3D-SPACE (3.57±0.65) in evaluating the detailed pathological structures, however, there was no signiifcant differences (U=65,P=0.099).Conclusion:3D-DESS is signiifcantly superior to 3D-SPACE in the evaluation of the detail of SP. Combined 3D-DESS and 3D-SPACE provide a noninvasive tool in the evaluation of SP.