Fu Qing, Cheng Qi-Guang, Kong Xiang-Chuang, Liu Ding-Xi, Guo Yi-Hao, Grinstead John, Zhang Xiao-Yong, Lei Zi-Qiao, Zheng Chuan-Sheng
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China.
Quant Imaging Med Surg. 2022 Jan;12(1):592-607. doi: 10.21037/qims-21-107.
We aimed to compare the performance of three contrast-enhanced T1-weighted three-dimensional (3D) magnetic resonance (MR) sequences to detect brain tumors at 3 Tesla. The three sequences were: (I) delay alternating with nutation for tailored excitation sampling perfection with application-optimized contrasts using different flip angle evolution (DANTE-SPACE), (II) pointwise encoding time reduction with radial acquisition (PETRA), and (III) magnetization-prepared rapid acquisition with gradient echo (MPRAGE).
This study involved 77 consecutive patients, including 34 patients with known primary brain tumors and 43 patients suspected of intracranial metastases. All patients underwent each of the three sequences with comparable spatial resolution and acquisition time post-injection. Signal-to-noise ratios (SNRs) for gray matter (GM) and white matter (WM), contrast-to-noise ratios (CNRs) for lesion/GM, lesion/WM, and GM/WM were quantitatively compared. Two radiologists determined the total number of enhancing lesions by consensus. Intraclass correlation coefficients (ICCs) between the two radiologists for metastases presence, qualitative ratings for image quality, and acoustic noise level of each sequence were assessed.
Among the three sequences, SNRs and CNRs between lesions and surrounding parenchyma were highest using DANTE-SPACE, but CNR was the lowest with DANTE-SPACE. SNRs for PETRA images were significantly higher than those for MPRAGE (P<0.001). CNRs between lesions and surrounding parenchyma were similar for PETRA and MPRAGE (P>0.05). Significantly more brain metastases were detected with DANTE-SPACE (n=94) compared with MPRAGE (n=71) and PETRA (n=72). The ICCs were 0.964 for MPRAGE, 0.975 for PETRA, and 0.973 for DANTE-SPACE. Qualitative scores for lesion imaging using DANTE-SPACE were significantly higher than those obtained with PETRA and MPRAGE (P=0.002 and P=0.004, respectively). The acoustic noise level for PETRA (64.45 dB) was significantly lower than that for MPRAGE (78.27 dB, P<0.01) and DANTE-SPACE (80.18 dB, P<0.01).
PETRA achieves comparable detection of brain tumors with MPRAGE and is preferred for depicting osseous metastases and meningeal enhancement. DANTE-SPACE with blood vessel suppression showed improved detection of cerebral metastases compared with MPRAGE and PETRA, which could be helpful for the differential diagnosis of tumors.
我们旨在比较三种对比增强T1加权三维（3D）磁共振（MR）序列在3特斯拉场强下检测脑肿瘤的性能。这三种序列分别为：（I）采用不同翻转角演变的延迟交替与章动以实现定制激发采样完美成像并应用优化对比（DANTE-SPACE）；（II）径向采集的逐点编码时间减少（PETRA）；（III）磁化准备快速梯度回波采集（MPRAGE）。
本研究纳入77例连续患者，包括34例已知原发性脑肿瘤患者和43例疑似颅内转移瘤患者。所有患者均接受了具有可比空间分辨率且注射后采集时间相同的这三种序列检查。对灰质（GM）和白质（WM）的信噪比（SNR）、病变/GM、病变/WM以及GM/WM的对比噪声比（CNR）进行了定量比较。两名放射科医生通过共识确定强化病变的总数。评估了两名放射科医生之间关于转移瘤存在情况的组内相关系数（ICC）、图像质量的定性评分以及每个序列的声学噪声水平。
在这三种序列中，DANTE-SPACE序列的病变与周围实质之间的SNR和CNR最高，但DANTE-SPACE序列的CNR最低。PETRA图像的SNR显著高于MPRAGE图像（P<0.001）。PETRA和MPRAGE序列的病变与周围实质之间的CNR相似（P>0.05）。与MPRAGE（n = 71）和PETRA（n = 72）相比，DANTE-SPACE序列检测到的脑转移瘤明显更多（n = 94）。MPRAGE序列的ICC为0.964，PETRA序列为0.975，DANTE-SPACE序列为0.973。使用DANTE-SPACE序列进行病变成像的定性评分显著高于PETRA和MPRAGE序列（分别为P = 0.002和P = 0.004）。PETRA序列的声学噪声水平（64.45 dB）显著低于MPRAGE序列（78.27 dB，P<0.01）和DANTE-SPACE序列（80.18 dB，P<0.01）。
PETRA在检测脑肿瘤方面与MPRAGE相当，并且在描绘骨转移瘤和脑膜强化方面更具优势。与MPRAGE和PETRA相比，具有血管抑制功能的DANTE-SPACE序列在检测脑转移瘤方面表现更佳，这有助于肿瘤的鉴别诊断。
