空洞症的稳态磁共振成像中的三维建设性干涉：相较于传统成像的优势

Three-dimensional constructive interference in steady-state magnetic resonance imaging in syringomyelia: advantages over conventional imaging.

作者信息

Roser Florian, Ebner Florian H, Danz Søren, Riether Felix, Ritz Rainer, Dietz Klaus, Naegele Thomas, Tatagiba Marcos S

机构信息

Department of Neurosurgery, University of Tübingen, Germany.

出版信息

J Neurosurg Spine. 2008 May;8(5):429-35. doi: 10.3171/SPI/2008/8/5/429.

DOI:10.3171/SPI/2008/8/5/429

PMID:18447688

Abstract

OBJECT

Neuroradiology has become indispensable in detecting the pathophysiology in syringomyelia. Constructive interference in steady-state (CISS) magnetic resonance (MR) imaging can provide superior contrast at the sub-arachnoid tissue borders. As this region is critical in preoperative evaluation, the authors hypothesized that CISS imaging would provide superior assessment of syrinx pathology and surgical planning.

METHODS

Based on records collected from a database of 130 patients with syringomyelia treated at the authors' institution, 59 patients were prospectively evaluated with complete neuroradiological examinations. In addition to routine acquisitions with FLAIR, T1- and T2-weighted, and contrast-enhanced MR imaging series, the authors obtained sagittal cardiac-gated sequences to visualize cerebrospinal fluid (CSF) pulsations and axial 3D CISS MR sequences to detect focal arachnoid webs. Statistical qualitative and quantitative evaluations of spinal cord/CSF contrast, spinal cord/CSF delineation, motion artifacts, and artifacts induced by pulsatile CSF flow were performed.

RESULTS

The 3D CISS MR sequences demonstrated a contrast-to-noise ratio significantly better than any other routine imaging sequence (p < 0.001). Moreover, 3D CISS imaging can detect more subarachnoid webs and cavitations in the syrinx than T2-weighted MR imaging with less flow-void artifact. The limitation of 3D CISS imaging is a susceptibility to motion artifacts that can cause reduced spatial resolution. Lengthy acquisition times for axial segments can be reduced with multiplanar reconstruction of 3D CISS-generated sagittal images.

CONCLUSIONS

Constructive interference in steady-state imaging is the MR sequence of choice in the preoperative evaluation of syringomyelia, allowing significantly higher detection rates of focal subarachnoid webs, whereas standard T2-weighted MR imaging shows turbulent CSF flow voids. Constructive interference in steady-state MR imaging enables the neurosurgeon to accurately identify cases requiring decompression for obstructed CSF. Motion artifacts can be eliminated with technical variations.

摘要

目的

神经放射学在检测脊髓空洞症的病理生理过程中已变得不可或缺。稳态构成性干扰（CISS）磁共振（MR）成像能够在蛛网膜下组织边界提供更好的对比度。由于该区域在术前评估中至关重要，作者推测CISS成像将能更好地评估脊髓空洞症的病理情况并用于手术规划。

方法

基于从作者所在机构治疗的130例脊髓空洞症患者数据库中收集的记录，对59例患者进行了全面的神经放射学检查。除了使用液体衰减反转恢复（FLAIR）、T1加权和T2加权以及增强磁共振成像系列进行常规采集外，作者还获取了矢状位心脏门控序列以观察脑脊液（CSF）搏动，并获取了轴位三维CISS MR序列以检测局灶性蛛网膜粘连。对脊髓/脑脊液对比度、脊髓/脑脊液边界清晰度、运动伪影以及由搏动性脑脊液流动引起的伪影进行了统计学定性和定量评估。

结果

三维CISS MR序列显示出的对比噪声比明显优于任何其他常规成像序列（p < 0.001）。此外，与T2加权MR成像相比，三维CISS成像能够检测到脊髓空洞症中更多的蛛网膜粘连和空洞，且流动空洞伪影更少。三维CISS成像的局限性在于易受运动伪影影响，这可能导致空间分辨率降低。通过对三维CISS生成的矢状位图像进行多平面重建，可以减少轴位节段冗长的采集时间。