3D 梯度回波 MR 成像序列通过脊髓与自旋回波 T1 在关注脊髓栓系的儿童中的诊断效用比较。

Diagnostic Utility of 3D Gradient-Echo MR Imaging Sequences through the Filum Compared with Spin-Echo T1 in Children with Concern for Tethered Cord.

机构信息

From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

出版信息

AJNR Am J Neuroradiol. 2023 Mar;44(3):323-327. doi: 10.3174/ajnr.A7791. Epub 2023 Feb 16.

DOI:10.3174/ajnr.A7791

PMID:36797030

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10187807/

Abstract

BACKGROUND AND PURPOSE

Fatty intrathecal lesions are a cause of tethered cord, and detection of these on spinal MR imaging is paramount. Conventional T1 FSE sequences are the mainstay of detecting fatty elements; however, 3D gradient-echo MR images, volumetric interpolated breath-hold examination/liver acquisition with volume acceleration (VIBE/LAVA), are popular, given the increased motion resistance. We sought to evaluate the diagnostic accuracy of VIBE/LAVA compared with T1 FSE for detection of fatty intrathecal lesions.

MATERIALS AND METHODS

In this retrospective, institutional review board-approved study, 479 consecutive pediatric spine MRIs obtained to evaluate cord tethering between January 2016 and April 2022 were reviewed. Inclusion criteria were patients who were 20 years of age or younger who underwent spine MRIs containing both axial T1 FSE and VIBE/LAVA sequences of the lumbar spine. The presence or absence of fatty intrathecal lesions was recorded for each sequence. If fatty intrathecal lesions were present, anterior-posterior and transverse dimensions were recorded. VIBE/LAVA and T1 FSE sequences were evaluated on 2 separate occasions (VIBE/LAVAs first followed by T1 FSE several weeks later) to minimize bias. Basic descriptive statistics compared fatty intrathecal lesion sizes on T1 FSEs and VIBE/LAVAs. Receiver operating characteristic curves were used to determine minimal fatty intrathecal lesion size detectable by VIBE/LAVA.

RESULTS

Sixty-six patients were included, with 22 having fatty intrathecal lesions (mean age, 7.2 years). T1 FSE sequences revealed fatty intrathecal lesions in 21/22 cases (95%); however, fatty intrathecal lesions on VIBE/LAVA were detected in 12/22 patients (55%). Mean anterior-posterior and transverse dimensions of fatty intrathecal lesions measured larger on T1 FSE compared with VIBE/LAVA sequences (5.4 × 5.0 mm versus 1.5 × 1.6 mm, respectively; values = .039 anterior-posterior; .027 transverse).

CONCLUSIONS

While T1 3D gradient-echo MR images may have decreased the acquisition time and are more motion-resistant than conventional T1 FSE sequences, they are less sensitive and may miss small fatty intrathecal lesions.

摘要

背景与目的

脂肪性脊髓内病变是脊髓栓系的原因之一，因此在脊髓磁共振成像（MRI）中检测到这些病变至关重要。常规 T1 快速自旋回波（FSE）序列是检测脂肪成分的主要方法；然而，由于运动阻力增加，三维梯度回波 MR 图像、容积内插屏气检查/肝脏采集加速（VIBE/LAVA）等技术更为流行。我们旨在评估 VIBE/LAVA 与 T1 FSE 检测脂肪性脊髓内病变的诊断准确性。

材料与方法

本回顾性研究经机构审查委员会批准，纳入 2016 年 1 月至 2022 年 4 月期间连续 479 例因脊髓栓系而行脊柱 MRI 检查的儿科患者。纳入标准为年龄在 20 岁及以下、接受包含轴向 T1 FSE 和腰椎 VIBE/LAVA 序列的脊柱 MRI 检查的患者。记录每个序列中脂肪性脊髓内病变的存在或不存在情况。如果存在脂肪性脊髓内病变，则记录其前后径和横径。为了尽量减少偏倚，VIBE/LAVA 和 T1 FSE 序列在两次不同的检查中进行评估（先进行 VIBE/LAVA 检查，几周后再进行 T1 FSE 检查）。使用基本描述性统计比较 T1 FSE 和 VIBE/LAVA 上脂肪性脊髓内病变的大小。使用受试者工作特征曲线确定 VIBE/LAVA 可检测到的最小脂肪性脊髓内病变大小。

结果

共纳入 66 例患者，其中 22 例存在脂肪性脊髓内病变（平均年龄 7.2 岁）。T1 FSE 序列在 21/22 例（95%）中发现了脂肪性脊髓内病变，而 VIBE/LAVA 在 12/22 例（55%）中发现了脂肪性脊髓内病变。与 VIBE/LAVA 序列相比，T1 FSE 序列上脂肪性脊髓内病变的前后径和横径更大（分别为 5.4×5.0mm 和 1.5×1.6mm；值分别为.039 前后径；.027 横径）。