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超长重复时间三维真实重建反转恢复序列评估内耳内淋巴积水成像的价值

Value of three-dimensional inversion-recovery with real reconstruction sequence using an ultralong repetition time for endolymphatic hydrops

    摘要
  • 摘要:
    目的 探讨基于调制反转角成像技术（modulated flip angle technique in refocused imaging with extended echo train, MATRIX）重复时间（repetition time, TR）为16 000 ms的改良三维真实重建反转恢复（three-dimensional inversion-recovery with real reconstruction, 3D-real IR）序列用于内耳内淋巴积水成像的效果，并与基于传统快速自旋回波（turbo spin echo, TSE）的经典3D-real IR（TR 6 000 ms）对比。
    方法 前瞻性分析2021年7月至2022年11月就诊于复旦大学附属中山医院并接受经鼓室注射钆对比剂后经典和改良3D-real IR扫描的27例患者的内耳图像。主观评价两组序列的图像质量，定量分析两组序列的信噪比、对比噪声比、耳蜗和前庭内淋巴间隙和膜迷路面积比，并比较。
    结果 经典3D-real IR序列图像上14（25.9%）耳的内、外淋巴间隙信号对比度不满足内淋巴积水诊断需求；改良3D-real IR序列图像上均能清晰显示。改良3D-real IR的图像质量评分、信噪比和对比噪声比均高于经典3D-real IR（P＜0.001），两者扫描时间相近。经典3D-real IR的耳蜗内淋巴间隙和膜迷路面积比高于改良3D-real IR（P＜0.001），两者前庭内淋巴间隙和膜迷路面积比差异无统计学意义。
    结论 经鼓室注射钆对比剂后，超长TR改良3D-real IR较经典3D-real IR更能清晰显示内耳内淋巴积水。

     

    Abstract:
    Objective To evaluate the value of an optimized three-dimensional inversion-recovery with real reconstruction (3D-real IR) sequence with a longer repetition time (TR, 16 000 ms) based on modulated flip angle technique in refocused imaging with extended echo train (MATRIX) in the endolymphatic hydrops (EH) imaging after intratympanic gadolinium (Gd) administration, and to compare it with a conventional 3D-real IR based on the turbo spin echo (TSE) sequence.
    Methods From July 2021 to November 2022, twenty-seven patients received both the conventional and optimized 3D-real IR sequences after bilateral intratympanic Gd administration. Images of the two sequences were qualitativly evaluated and compared. Contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and area ratio of endolymph against the total lymphatic space from the two sequences were measured and compared.
    Results 14(25.9%) ears with insufficient contrast for the EH diagnosis on the conventional sequence were clearly displayed on the optimized sequence. Image score, CNR and SNR of the optimized sequence were significantly higher than those of the conventional sequence (P ＜ 0.001). The scanning time of two sequences was similar. The area ratio of endolymph against the total lymphatic space in the cochlear was significantly higher on the conventional 3D-real IR than that on the optimized 3D-real IR (P ＜ 0.001); there was no statistical difference in the vestibule between the two sequences.
    Conclusions Compared with conventional sequence, optimized 3D-real IR sequence with a longer TR may be better for evaluation of EH after intratympanic Gd administration.

     

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