Ogawa Masaki, Omata Shingo, Kan Hirohito, Arai Nobuyuki, Asai Marehiko, Urano Misugi, Shibamoto Yuta
Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
Department of Radiology, Nagoya City University Hospital, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
Radiol Phys Technol. 2018 Jun;11(2):228-234. doi: 10.1007/s12194-018-0460-7. Epub 2018 Apr 25.
We aimed to investigate the utility of the isoFSE sequence, one of the variable flip angle 3D fast-spin echo sequences, on 3T-MR for displaying vessel walls and diagnosing vertebrobasilar artery dissection (VAD). We retrospectively evaluated 12 initial and 28 follow-up images from 12 patients diagnosed with either intracranial VAD or carotid artery dissection. The image quality for displaying the vessel wall was scored using a five-point scale (1 poor, 5 excellent) on initial T1-weighted isoFSE images for each region of the arteries. The intracranial artery dissection findings assessed at time points after onset were evaluated on initial and follow-up T1/T2-weighted isoFSE images. For small arteries, including the anterior/posterior inferior cerebellar artery, similar high scores were obtained on both unenhanced and contrast-enhanced T1-weighted isoFSE images (average: 4.7-5.0, p > 0.2). On unenhanced images, dissected vertebral arteries showed significantly lower scores than non-dissected vertebral arteries for both readers (p = 0.017 and 0.015, respectively), but the scores were high (3.9 and 4.0, respectively). Definitive findings of VAD were observed on the initial images except in one case. For all cases, definitive findings were seen on at least one of the initial or follow-up images. Temporal changes in the findings could be observed for all cases. In conclusion, we showed favorable wall visualization on T1-weighted isoFSE images and the utility of follow-up imaging using unenhanced-T1/T2-weighted and contrast-enhanced T1-weighted isoFSE sequences with acceptable scan times, which could promote the regular use of 3D black-blood vessel wall imaging.
我们旨在研究可变翻转角3D快速自旋回波序列之一的isoFSE序列在3T磁共振成像（MR）上显示血管壁和诊断椎基底动脉夹层（VAD）的效用。我们回顾性评估了12例诊断为颅内VAD或颈动脉夹层患者的12份初始图像和28份随访图像。在每个动脉区域的初始T1加权isoFSE图像上，使用五分制（1分差，5分优）对显示血管壁的图像质量进行评分。在初始和随访的T1/T2加权isoFSE图像上评估发病后各时间点的颅内动脉夹层表现。对于包括小脑前下/后下动脉在内的小动脉，在未增强和对比增强的T1加权isoFSE图像上均获得了相似的高分（平均：4.7 - 5.0，p > 0.2）。在未增强图像上，两位读者对夹层椎动脉的评分均显著低于未夹层椎动脉（p分别为0.017和0.015），但评分较高（分别为3.9和4.0）。除1例患者外，在初始图像上均观察到VAD的确切表现。对于所有病例，在初始或随访图像中至少有一张上能看到确切表现。所有病例均可观察到表现的时间变化。总之，我们在T1加权isoFSE图像上显示了良好的血管壁可视化效果，以及使用未增强T1/T2加权和对比增强T1加权isoFSE序列进行随访成像的效用，且扫描时间可接受，这可能会促进3D黑血血管壁成像的常规应用。
