Brichtová Eva, Šenkyřík J
Department of Neurosurgery, St. Anne´s University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Department of Pediatric Radiology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Childs Nerv Syst. 2017 May;33(5):753-758. doi: 10.1007/s00381-017-3385-2. Epub 2017 Mar 24.
A low radiation burden is essential during diagnostic procedures in pediatric patients due to their high tissue sensitivity. Using MR examination instead of the routinely used CT reduces the radiation exposure and the risk of adverse stochastic effects. Our retrospective study evaluated the possibility of using ultrafast single-shot (SSh) sequences and turbo spin echo (TSE) sequences in rapid MR brain imaging in pediatric patients with hydrocephalus and a programmable ventriculoperitoneal drainage system.
SSh sequences seem to be suitable for examining pediatric patients due to the speed of using this technique, but significant susceptibility artifacts due to the programmable drainage valve degrade the image quality. Therefore, a rapid MR examination protocol based on TSE sequences, less sensitive to artifacts due to ferromagnetic components, has been developed. Of 61 pediatric patients who were examined using MR and the SSh sequence protocol, a group of 15 patients with hydrocephalus and a programmable drainage system also underwent TSE sequence MR imaging. The susceptibility artifact volume in both rapid MR protocols was evaluated using a semiautomatic volumetry system.
A statistically significant decrease in the susceptibility artifact volume has been demonstrated in TSE sequence imaging in comparison with SSh sequences. Using TSE sequences reduced the influence of artifacts from the programmable valve, and the image quality in all cases was rated as excellent. In all patients, rapid MR examinations were performed without any need for intravenous sedation or general anesthesia.
Our study results strongly suggest the superiority of the TSE sequence MR protocol compared to the SSh sequence protocol in pediatric patients with a programmable ventriculoperitoneal drainage system due to a significant reduction of susceptibility artifact volume. Both rapid sequence MR protocols provide quick and satisfactory brain imaging with no ionizing radiation and a reduced need for intravenous or general anesthesia.
由于小儿患者组织敏感性高，在其诊断过程中低辐射负担至关重要。使用磁共振成像（MR）检查而非常规使用的计算机断层扫描（CT）可减少辐射暴露及不良随机效应风险。我们的回顾性研究评估了在患有脑积水且带有可编程脑室腹腔分流系统的小儿患者的快速MR脑成像中使用超快单次激发（SSh）序列和快速自旋回波（TSE）序列的可能性。
由于使用该技术的速度，SSh序列似乎适用于检查小儿患者，但可编程引流阀导致的显著磁敏感伪影会降低图像质量。因此，已开发出一种基于TSE序列的快速MR检查方案，该方案对铁磁成分引起的伪影不太敏感。在61例使用MR和SSh序列方案进行检查的小儿患者中，一组15例患有脑积水且带有可编程引流系统的患者也接受了TSE序列MR成像。使用半自动容积测量系统评估两种快速MR方案中的磁敏感伪影体积。
与SSh序列相比，TSE序列成像中的磁敏感伪影体积有统计学意义的显著减少。使用TSE序列减少了可编程阀产生的伪影影响，所有病例的图像质量均被评为优秀。所有患者在无需任何静脉镇静或全身麻醉的情况下完成了快速MR检查。
我们的研究结果有力地表明，对于患有可编程脑室腹腔分流系统的小儿患者，TSE序列MR方案优于SSh序列方案，因为磁敏感伪影体积显著减少。两种快速序列MR方案均可提供快速且令人满意的脑成像，无电离辐射，且减少了对静脉或全身麻醉的需求。
