Departments of Radiology and Neurological Surgery, Weill Cornell Medical College, 525 E 68th St, Box 141, New York, NY, 10021.
Radiology. 2013 Oct;269(1):216-23. doi: 10.1148/radiol.13121991. Epub 2013 May 14.
To assess quantitative susceptibility mapping (QSM) in the depiction of the subthalamic nucleus (STN) by using 3-T magnetic resonance (MR) imaging.
This study was HIPAA compliant and institutional review board approved. Ten healthy subjects (five men, five women; mean age, 24 years ± 3 [standard deviation]; age range, 21-33 years) and eight patients with Parkinson disease (five men, three women; mean age, 57 years ± 14; age range, 25-69 years) who were referred by neurologists for preoperative navigation MR imaging prior to deep brain stimulator placement were included in this study. T2-weighted (T2w), T2*-weighted (T2w), R2 mapping (R2*), phase, susceptibility-weighted (SW), and QSM images were reconstructed for STN depiction. Qualitative visualization scores of STN and internal globus pallidus (GPi) were recorded by two neuroradiologists on all images. Contrast-to-noise ratios (CNRs) of the STN and GPi were also measured. Measurement differences were assessed by using the Wilcoxon rank sum test and the signed rank test.
Qualitative scores were significantly higher on QSM images than on T2w, T2w, R2, phase, or SW images (P < .05) for STN and GPi visualization. Median CNR was 6.4 and 10.7 times higher on QSM images than on T2w images for differentiation of STN from the zona incerta and substantia nigra, respectively, and was 22.7 and 9.1 times higher on QSM images than on T2w images for differentiation of GPi from the internal capsule and external globus pallidus, respectively. CNR differences between QSM images and all other images were significant (P < .01).
QSM at 3-T MR imaging performs significantly better than current standard-of-care sequences in the depiction of the STN.
利用 3T 磁共振（MR）成像评估定量磁化率映射（QSM）在丘脑底核（STN）显示中的作用。
本研究符合 HIPAA 规定和机构审查委员会的批准。共纳入 10 名健康受试者（5 名男性，5 名女性；平均年龄 24 岁±3[标准差]；年龄范围 21-33 岁）和 8 名因深部脑刺激器植入术前导航 MR 成像而由神经科医生转诊的帕金森病患者（5 名男性，3 名女性；平均年龄 57 岁±14；年龄范围 25-69 岁）。为了显示 STN，重建了 T2 加权（T2w）、T2*-加权（T2w）、R2映射（R2*）、相位、磁化率加权（SW）和 QSM 图像。两名神经放射科医生对所有图像的 STN 和内苍白球（GPi）的定性可视化评分进行了记录。还测量了 STN 和 GPi 的对比噪声比（CNR）。采用 Wilcoxon 秩和检验和符号秩检验评估测量差异。
在 STN 和 GPi 的可视化方面，QSM 图像的定性评分明显高于 T2w、T2w、R2、相位或 SW 图像（P<.05）。与 T2w 图像相比，QSM 图像区分 STN 与未定带和黑质的平均 CNR 分别高 6.4 倍和 10.7 倍，区分 GPi 与内囊和外苍白球的平均 CNR 分别高 22.7 倍和 9.1 倍。QSM 图像与所有其他图像之间的 CNR 差异均具有统计学意义（P<.01）。
与现行的标准护理序列相比，3T MR 成像的 QSM 在 STN 显示方面表现出色。
