Ross M R, Schomer D F, Chappell P, Enzmann D R
Department of Radiology, Stanford University Medical Center, CA.
AJR Am J Roentgenol. 1994 Jul;163(1):173-8. doi: 10.2214/ajr.163.1.8010208.
The purpose of this study was to determine the value of three MR pulse sequences for the detection of tumors and abnormal lymph nodes in the head and neck. This was accomplished by quantifying differences in contrast between tumor, lymph node, and respective adjacent tissue on contrast-enhanced fat-suppressed T1-weighted MR images, conventional spin-echo T2-weighted images, and fast spin-echo fat-suppressed T2-weighted images in a group of patients with head and neck tumors.
Two groups of patients with head and neck tumors were studied. In the first group (16 patients), contrast-enhanced fat-suppressed T1-weighted images were compared with conventional spin-echo T2-weighted images. In the second group (21 patients), contrast-enhanced fat-suppressed T1-weighted images were compared with fast spin-echo fat-suppressed T2-weighted images. The detectability of tumor and abnormal lymph nodes was measured by calculating the contrast-to-noise ratio.
The fat-suppressed T1-weighted images had significantly higher (p < or = .02) contrast-to-noise ratios for both the primary tumor and lymph nodes than either conventional or fast spin-echo T2-weighted images did. However, subjective evaluation of the contrast-to-noise ratios proved satisfactory for tumor detection with all three imaging sequences (contrast-enhanced fat-suppressed T1-weighted, fast spin-echo fat-suppressed T2-weighted, and conventional T2-weighted).
Our results show that fat-suppressed contrast-enhanced T1-weighted images provide the highest contrast-to-noise ratio for head and neck tumors and abnormal lymph nodes. However, head and neck tumors encompass a broad range of neoplasms that are distributed in a complicated anatomic area. Therefore, in some patients, a combination of contrast-enhanced fat-suppressed T1- and T2-weighted images, preferably fast spin-echo fat-suppressed images, is useful for detection of these tumors and nodal metastases.
本研究旨在确定三种磁共振脉冲序列对头颈部肿瘤及异常淋巴结的检测价值。通过对一组头颈部肿瘤患者的增强脂肪抑制T1加权磁共振图像、传统自旋回波T2加权图像及快速自旋回波脂肪抑制T2加权图像上肿瘤、淋巴结及其各自相邻组织之间的对比度差异进行量化来实现这一目的。
对头颈部肿瘤患者进行了两组研究。第一组（16例患者），将增强脂肪抑制T1加权图像与传统自旋回波T2加权图像进行比较。第二组（21例患者），将增强脂肪抑制T1加权图像与快速自旋回波脂肪抑制T2加权图像进行比较。通过计算对比噪声比来测量肿瘤及异常淋巴结的可检测性。
脂肪抑制T1加权图像上原发肿瘤和淋巴结的对比噪声比均显著高于传统或快速自旋回波T2加权图像（p≤0.02）。然而，对所有三种成像序列（增强脂肪抑制T1加权、快速自旋回波脂肪抑制T2加权和传统T2加权）的对比噪声比进行主观评估，结果表明对肿瘤检测均令人满意。
我们的结果表明，脂肪抑制增强T1加权图像对头颈部肿瘤及异常淋巴结具有最高的对比噪声比。然而，头颈部肿瘤包含多种肿瘤类型，分布于复杂的解剖区域。因此，对于某些患者，增强脂肪抑制T1加权和T2加权图像（最好是快速自旋回波脂肪抑制图像）联合使用，有助于这些肿瘤及淋巴结转移的检测。
