Ross J S, Ruggieri P M, Glicklich M, Obuchowski N, Dillinger J, Masaryk T J, Qu Y, Modic M T
Division of Radiology, Cleveland Clinic Foundation, OH 44195.
J Comput Assist Tomogr. 1993 Jan-Feb;17(1):26-33.
The authors undertook this study to compare bright and dark CSF three-dimensional (3D) gradient-echo (GE) MR techniques to answer the following questions: Could a single Gd-DTPA enhanced T1-weighted GE volume sequence (with multiplanar reformats) be diagnostically equivalent for degenerative cervical disk disease to a standard sequence consisting of sagittal T1-weighted spin echo and axial low flip angle volume GE images (with reformatted images)? Does performing oblique coronal reformats perpendicular to the course of exiting cervical nerve roots improve diagnostic confidence over axial images alone? Thirty-one consecutive patients received a "routine" MR examination consisting of a sagittal T1-weighted spin echo and axial low flip angle volume sequence (FISP) [(35/7/5), 64 slices, 2 mm slice thickness, 192 x 256 matrix, 7.2 min]. Each patient was then given 0.1 mmol/kg Gd-DTPA intravenously, and reimaged with a T1-weighted volume GE sequence [(13/6/12), acquired as 128-1.2 mm coronal partitions, 192 x 256 matrix, 5.5 min]. Sequences were reconstructed on the standard diagnostic console in 1 mm increments. Sets of examinations (routine vs T1-weighted volume) were independently interpreted by three neuroradiologists for location, type, and severity of extradural degenerative disease. There was no strong or consistent trend for increased detection of disease by one imaging sequence over the other. For lateral disk disease, only 3% of the observations were in discordance. For disk disease, there was close agreement in the severity scores. All readers indicated that additional information was provided by the reformatted images more frequently with TurboFLASH (fast low angle shot) than with FISP. All readers indicated that increased confidence was provided by the reformatted images more frequently with TurboFLASH than with FISP. A single 3D contrast-enhanced TurboFLASH sequence is diagnostically equivalent to a set of two-dimensional T1-weighted sagittal spin echo and 3D axial low flip angle sequences for assessing the location and degree of cervical extradural degenerative disease. A screening examination of the cervical spine could be performed with a single contrast-enhanced 5.2 min study, and then relying on computer postprocessing to provide additional imaging planes.
作者开展本研究以比较亮脑脊液和暗脑脊液三维（3D）梯度回波（GE）磁共振技术，以回答以下问题：对于退行性颈椎间盘疾病，单次钆喷酸葡胺增强T1加权GE容积序列（含多平面重组）在诊断上是否等同于由矢状位T1加权自旋回波和轴位低翻转角容积GE图像（含重组图像）组成的标准序列？与仅采用轴位图像相比，进行垂直于出颈神经根走行的斜冠状面重组是否能提高诊断信心？31例连续患者接受了一次“常规”磁共振检查，包括矢状位T1加权自旋回波和轴位低翻转角容积序列（快速成像稳态进动序列）[（35/7/5），64层，2mm层厚，192×256矩阵，7.2分钟]。然后给每位患者静脉注射0.1mmol/kg钆喷酸葡胺，并采用T1加权容积GE序列再次成像[（13/6/12），采集为128个1.2mm冠状分区，192×256矩阵，5.5分钟]。序列在标准诊断控制台以1mm增量重建。由三位神经放射科医生独立解读检查组（常规检查与T1加权容积检查），以确定硬膜外退行性疾病的位置、类型和严重程度。一种成像序列在疾病检测方面相对于另一种成像序列没有明显或一致的增加趋势。对于外侧椎间盘疾病，仅3%的观察结果不一致。对于椎间盘疾病，严重程度评分高度一致。所有阅片者均表示，与快速成像稳态进动序列相比，TurboFLASH（快速低角度激发）重组图像更频繁地提供了额外信息。所有阅片者均表示，与快速成像稳态进动序列相比，TurboFLASH重组图像更频繁地提高了信心。单次3D对比增强TurboFLASH序列在评估颈椎硬膜外退行性疾病的位置和程度方面，在诊断上等同于一组二维T1加权矢状位自旋回波和3D轴位低翻转角序列。可以通过单次5.2分钟的对比增强研究对颈椎进行筛查检查，然后依靠计算机后处理提供额外的成像平面。
