Robert Steiner MRI Unit, Imaging Sciences Department, Clinical Sciences Centre, Hammersmith Hospital Campus, Imperial College, DuCane Rd, London W12 0HS, England.
Radiology. 2011 Jan;258(1):229-35. doi: 10.1148/radiol.10100381. Epub 2010 Oct 27.
To prospectively evaluate the clinical effectiveness of snapshot inversion recovery (SNAPIR), which is a dedicated optimized inversion-recovery-prepared single-shot fast spin-echo T1-weighted sequence, in the delineation of normal fetal brain anatomy compared with that of the currently used T1-weighted gradient-echo protocol, which often yields images of poor quality due to motion artifacts and inadequate contrast.
This study was approved by the hospital research ethics committee, and informed written consent was obtained from all patients. Forty-one fetuses were examined at 19-37 weeks gestation (mean, 29 weeks gestation) by using both the standard T1-weighted protocol and the optimized T1-weighted SNAPIR protocol with a 1.5-T imager. Two independent blinded observers performed qualitative analysis, evaluating overall diagnostic quality, detailed anatomic delineation, and severity of motion artifacts. Quantitative analysis comprised calculation of contrast ratios (CRs) for the cortical gray matter, subplate, white matter, and cerebrospinal fluid. The Wilcoxon signed rank test was used to compare image rating scores, the paired t test was used to compare CRs, and κ statistics were used to test interobserver agreement.
Both overall diagnostic quality (P < .001) and detailed anatomic delineation (P < .001) were enhanced with SNAPIR compared with the standard T1-weighted acquisition. Also, motion artifacts were less severe (P = .008) and less extensive (P < .001) with SNAPIR. Corresponding CRs were increased with SNAPIR in seven of eight examined regions.
SNAPIR is a promising robust alternative to the current T1-weighted acquisitions; its role in the detection of disease requires further study.
前瞻性评估 snapshot 反转恢复(SNAPIR)的临床有效性,该技术是一种专门优化的反转恢复准备的单次快速自旋回波 T1 加权序列,与目前常用的因运动伪影和对比度不足而导致图像质量较差的 T1 加权梯度回波方案相比,用于描绘正常胎儿脑解剖结构。
本研究经医院研究伦理委员会批准,并获得所有患者的书面知情同意。使用 1.5T 成像仪对 41 例 19-37 孕周(平均 29 孕周)胎儿进行标准 T1 加权方案和优化 T1 加权 SNAPIR 方案检查。两名独立的盲法观察者进行定性分析,评估整体诊断质量、详细解剖描绘和运动伪影的严重程度。定量分析包括计算皮质灰质、基板、白质和脑脊液的对比比(CR)。采用 Wilcoxon 符号秩检验比较图像评分,采用配对 t 检验比较 CR,采用κ统计检验评估观察者间一致性。
与标准 T1 加权采集相比,SNAPIR 可提高整体诊断质量(P <.001)和详细解剖描绘(P <.001)。此外,SNAPIR 可减少运动伪影的严重程度(P =.008)和范围(P <.001)。SNAPIR 可使 8 个检查区域中的 7 个区域的 CR 增加。
SNAPIR 是一种有前途的替代目前 T1 加权采集的方法;其在疾病检测中的作用需要进一步研究。