From Philips Healthcare (M.B.O., I.E.D., H.T.F., Q.L., H.W., Y.W., Y.Z.)
Gainesville, Florida; Barrow Neurological Institute (Z.L., A.G.A., N.R.Z., J.P.K.).
AJNR Am J Neuroradiol. 2020 Feb;41(2):238-245. doi: 10.3174/ajnr.A6409. Epub 2020 Feb 6.
Spiral MR imaging has several advantages compared with Cartesian MR imaging that can be leveraged for added clinical value. A multicenter multireader study was designed to compare spiral with standard-of-care Cartesian postcontrast structural brain MR imaging on the basis of relative performance in 10 metrics of image quality, artifact prevalence, and diagnostic benefit.
Seven clinical sites acquired 88 total subjects. For each subject, sites acquired 2 postcontrast MR imaging scans: a spiral 2D T1 spin-echo, and 1 of 4 routine Cartesian 2D T1 spin-echo/TSE scans (fully sampled spin-echo at 3T, 1.5T, partial Fourier, TSE). The spiral acquisition matched the Cartesian scan for scan time, geometry, and contrast. Nine neuroradiologists independently reviewed each subject, with the matching pair of spiral and Cartesian scans compared side-by-side, and scored on 10 image-quality metrics (5-point Likert scale) focused on intracranial assessment. The Wilcoxon signed rank test evaluated relative performance of spiral versus Cartesian, while the Kruskal-Wallis test assessed interprotocol differences.
Spiral was superior to Cartesian in 7 of 10 metrics (flow artifact mitigation, SNR, GM/WM contrast, image sharpness, lesion conspicuity, preference for diagnosing abnormal enhancement, and overall intracranial image quality), comparable in 1 of 10 metrics (motion artifacts), and inferior in 2 of 10 metrics (susceptibility artifacts, overall extracranial image quality) related to magnetic susceptibility ( < .05). Interprotocol comparison confirmed relatively higher SNR and GM/WM contrast for partial Fourier and TSE protocol groups, respectively ( < .05).
Spiral 2D T1 spin-echo for routine structural brain MR imaging is feasible in the clinic with conventional scanners and was preferred by neuroradiologists for overall postcontrast intracranial evaluation.
与笛卡尔磁共振成像相比，螺旋磁共振成像具有多项优势，可带来附加的临床价值。本多中心多读者研究旨在基于 10 项图像质量、伪影发生率和诊断获益指标的相对表现，比较螺旋与标准笛卡尔对比增强结构脑磁共振成像。
7 个临床站点共采集 88 例受试者。对于每个受试者，各站点采集 2 次对比增强磁共振成像扫描：1 次螺旋 2D T1 自旋回波，和 1 次常规笛卡尔 2D T1 自旋回波/TSE 扫描中的 4 种之一（3T 全采样自旋回波、1.5T、部分傅里叶、TSE）。螺旋采集在扫描时间、几何形状和对比方面与笛卡尔扫描匹配。9 位神经放射科医生独立评估每个受试者，将匹配的螺旋和笛卡尔扫描并排比较，并对 10 项侧重于颅内评估的图像质量指标（5 分 Likert 量表）进行评分。Wilcoxon 符号秩检验评估螺旋与笛卡尔的相对性能，而 Kruskal-Wallis 检验评估协议间差异。
螺旋在 10 项指标中的 7 项优于笛卡尔（流动伪影减轻、SNR、GM/WM 对比、图像清晰度、病灶显著性、诊断异常增强的偏好以及整体颅内图像质量），在 10 项指标中的 1 项相当（运动伪影），在 10 项指标中的 2 项中较差（磁化率相关的磁化率伪影和整体颅外图像质量）（ <.05）。协议间比较证实部分傅里叶和 TSE 协议组的 SNR 和 GM/WM 对比度相对较高（ <.05）。
常规扫描仪可在临床中实现常规结构脑磁共振成像的螺旋 2D T1 自旋回波，神经放射科医生更喜欢用于整体对比增强颅内评估。
