表皮样囊肿患者中扩散加权成像（DWI）技术的比较：半傅里叶单次激发快速自旋回波刀锋技术DWI与单次激发自旋回波EPI DWI的比较
Comparison of DWI techniques in patients with epidermoid cyst: TGSE-BLADE DWI vs. SS-EPI DWI.
作者信息
Otani Sayo, Fushimi Yasutaka, Okuchi Sachi, Sakata Akihiko, Yamamoto Takayuki, Nakajima Satoshi, Wang Yang, Ikeda Satoshi, Ito Shuichi, Yasumura Sumika, Takada Shigeki, Sano Noritaka, Ueno Kentaro, Urushibata Yuta, Zhou Kun, Arakawa Yoshiki, Nakamoto Yuji
机构信息
Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Kyoto, 6068507, Japan.
Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
出版信息
Jpn J Radiol. 2025 May;43(5):752-760. doi: 10.1007/s11604-024-01717-x. Epub 2024 Dec 28.
PURPOSE
To compare quantitative values and image quality between single-shot echo-planar imaging (SS-EPI) diffusion-weighted imaging (DWI) and two-dimensional turbo gradient- and spin-echo DWI with non-Cartesian BLADE trajectory (TGSE-BLADE DWI) in patients with epidermoid cyst.
METHODS
Patients with epidermoid cyst who underwent both SS-EPI DWI and TGSE-BLADE DWI were included in this study. Two raters placed ROIs encircling the entire epidermoid cyst on SS-EPI DWI, and then on TGSE-BLADE DWI. Apparent diffusion coefficient (ADC) of the epidermoid cyst was measured within each ROI, then the intraclass correlation coefficient (ICC) between raters was obtained for each DWI. The areas of ROIs placed by the two raters were measured and compared using the Dice coefficient. In the selected slice analysis, one rater selected the most appropriate slice and carefully placed the ROIs slightly smaller than the epidermoid outline to avoid artifacts. Image quality analysis was assessed qualitatively for geometric distortion, susceptibility artifacts, lesion conspicuity, and diagnostic confidence. ADCs for both DWI techniques were compared with theoretical values derived from the diffusion phantom.
RESULTS
Twenty patients with epidermoid cyst were included in this study. The ICC of ADC measured by the two raters for TGSE-BLADE (0.80) was higher than that for SS-EPI (0.59). Dice coefficient of ROI areas was significantly higher with TGSE-BLADE (0.78) than with SS-EPI (0.71, P = 0.007). Selected slice analysis showed that the ADC of epidermoid cyst was significantly higher with TGSE-BLADE DWI than with SS-EPI DWI (P < 0.001). ADCs measured from carefully selected ROIs avoiding artifacts with the two techniques correlated positively (r = 0.87, P < 0.001; ICC 0.75). TGSE-BLADE DWI rated better for image quality than SS-EPI DWI according to all raters. ICCs of measured ADC and theoretical ADCs exceeded 0.99 for both techniques.
CONCLUSIONS
TGSE-BLADE DWI appears more suitable than SS-EPI DWI for evaluating epidermoid cyst.
目的
比较单次激发回波平面成像（SS-EPI）扩散加权成像（DWI）与具有非笛卡尔刀锋轨迹的二维 turbo 梯度和自旋回波 DWI（TGSE-BLADE DWI）在表皮样囊肿患者中的定量值和图像质量。
方法
本研究纳入了同时接受 SS-EPI DWI 和 TGSE-BLADE DWI 的表皮样囊肿患者。两名评估者在 SS-EPI DWI 上围绕整个表皮样囊肿放置感兴趣区（ROI），然后在 TGSE-BLADE DWI 上进行同样操作。在每个 ROI 内测量表皮样囊肿的表观扩散系数（ADC），然后获得每个 DWI 评估者之间的组内相关系数（ICC）。使用 Dice 系数测量并比较两名评估者放置的 ROI 面积。在选定切片分析中，一名评估者选择最合适的切片，并小心放置略小于表皮样囊肿轮廓的 ROI 以避免伪影。对图像质量进行定性评估，包括几何畸变、磁敏感伪影、病变清晰度和诊断置信度。将两种 DWI 技术的 ADC 与扩散模型得出的理论值进行比较。
结果
本研究纳入了 20 例表皮样囊肿患者。两名评估者测量的 TGSE-BLADE 的 ADC 的 ICC（0.80）高于 SS-EPI（0.59）。TGSE-BLADE 的 ROI 面积的 Dice 系数（0.78）显著高于 SS-EPI（0.71，P = 0.007）。选定切片分析显示，TGSE-BLADE DWI 的表皮样囊肿 ADC 显著高于 SS-EPI DWI（P < 0.001）。两种技术通过仔细选择避免伪影的 ROI 测量的 ADC 呈正相关（r = 0.87，P < 0.001；ICC 0.75）。根据所有评估者的评价，TGSE-BLADE DWI 的图像质量优于 SS-EPI DWI。两种技术测量的 ADC 与理论 ADC 的 ICC 均超过 0.99。
结论
对于评估表皮样囊肿，TGSE-BLADE DWI 似乎比 SS-EPI DWI 更合适。
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