Department of Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan.
Radiology. 2011 Jan;258(1):154-63. doi: 10.1148/radiol.10100866. Epub 2010 Nov 2.
To compare a three-dimensional (3D) T2-weighted turbo spin-echo (TSE) magnetic resonance (MR) sequence (VISTA; Philips Medical Systems, Best, the Netherlands) with a two-dimensional (2D) T2-weighted TSE sequence in terms of image quality, signal intensity (SI) difference ratios, conspicuity, and staging of uterine tumors.
This retrospective study was approved by the institutional review board, and informed consent was waived. Sixty-one women (mean age, 53.0 years ± 13.7 [standard deviation]; range, 30-87 years) with cervical carcinoma (n = 28), endometrial carcinoma (n = 21), or leiomyoma (n = 30) of the uterus were included. Patients underwent T2-weighted MR imaging at 3 T with both 1-mm-thick 3D and 5-mm-thick 2D T2-weighted TSE sequences. Three-dimensional T2-weighted TSE images were reconstructed at 5-mm thickness with the aid of a workstation. Quantitative analyses of signal-to-noise ratio (SNR) and SI difference ratios between tumors and other tissues and qualitative analyses of image quality and tissue conspicuity were performed. Two radiologists independently assessed local-regional staging for carcinomas. Quantitative values, qualitative scores, and tumor staging were analyzed by using the paired t test, Wilcoxon signed rank test, and McNemar test, respectively.
Mean myometrial SNR was higher on 3D than 2D images (14.3 vs 9.8; P < .0001). Mean SI difference ratios between cervical (0.45 vs 0.34; P < .0001) or endometrial (0.46 vs 0.40; P = .044) carcinomas and gluteal muscle were higher on 3D images, but those between leiomyoma and myometrium (0.33 vs 0.43; P < .0001) were lower than those on 2D images. Image quality (P = .0004) and carcinoma conspicuity (P < .0005) were superior with the 3D T2-weighted TSE sequence. Although multiplanar reconstruction of 3D T2-weighted TSE images was useful for staging in one case, there were no significant differences between 3D and 2D T2-weighted TSE imaging in accuracy of staging for the two readers for cervical or endometrial carcinoma.
The 3D T2-weighted TSE sequence showed certain advantages over the 2D T2-weighted TSE sequence, and it has the potential to improve the performance of MR imaging for the evaluation of uterine carcinoma.
比较三维（3D）T2 加权涡轮自旋回波（TSE）磁共振（MR）序列（VISTA；荷兰飞利浦医疗系统公司）与二维（2D）T2 加权 TSE 序列在子宫肿瘤的图像质量、信号强度（SI）差异比、显示度和分期方面的差异。
本回顾性研究经机构审查委员会批准，并豁免了知情同意。纳入 61 例经宫颈（n=28）、子宫内膜（n=21）或子宫平滑肌瘤（n=30）患者，年龄 30-87 岁，平均 53.0 岁±13.7 岁（标准差）。患者在 3T 场强下进行 T2 加权 MR 成像，均采用 1-mm 厚的 3D 和 5-mm 厚的 2D T2 加权 TSE 序列。借助工作站，将 3D T2 加权 TSE 图像重建为 5-mm 厚。对肿瘤与其他组织的信噪比（SNR）和 SI 差异比进行定量分析，对图像质量和组织显示度进行定性分析。两名放射科医生独立评估癌症的局部区域分期。分别采用配对 t 检验、Wilcoxon 符号秩检验和 McNemar 检验分析定量值、定性评分和肿瘤分期。
3D 图像的子宫肌 SNR 高于 2D 图像（14.3 比 9.8；P＜0.0001）。宫颈（0.45 比 0.34；P＜0.0001）或子宫内膜（0.46 比 0.40；P=0.044）癌与臀肌的平均 SI 差异比在 3D 图像上更高，但平滑肌瘤与子宫肌的 SI 差异比（0.33 比 0.43；P＜0.0001）则低于 2D 图像。3D T2 加权 TSE 序列的图像质量（P=0.0004）和癌显示度（P＜0.0005）更好。虽然 3D T2 加权 TSE 图像的多平面重建对于一种情况的分期有用，但两位放射科医生在宫颈或子宫内膜癌的分期准确性方面，3D 和 2D T2 加权 TSE 成像之间没有显著差异。
与 2D T2 加权 TSE 序列相比，3D T2 加权 TSE 序列具有一定优势，有望提高 MR 成像在子宫癌评估中的性能。
