Jeong M G, Chung T S, Coe C J, Jeon T J, Kim D I, Joo A Y
Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, Korea.
J Comput Assist Tomogr. 1997 Jan-Feb;21(1):8-14. doi: 10.1097/00004728-199701000-00002.
Our goal was to assess the effectiveness of magnetization transfer imaging (MTI) and the usefulness of the magnetization transfer ratio (MTR) in tuberous sclerosis (TS).
T2- and T1-weighted SE images with saturation pulse on/off before and after gadolinium enhancement in 10 patients with TS were obtained. The numbers of subependymal nodule (SEN), cortical tuber, and white matter (WM) abnormality detected on T1-, proton density, T2-, and MT T1-weighted SE images were compared. The contrast-to-noise ratio (C/N) on T1-, MT T1-, Gd T1-, and Gd MT T1-weighted SE images and MTR (1-Msat/MO) on each set of saturation/nonsaturation images for each lesions were calculated. Mean MTRs (mMTRs) of WM and gray matter (GM) from seven normal volunteers were also obtained.
MT T1-weighted SE images always depicted all lesions seen on conventional MRI and allowed depiction of more SENs (n = 80), cortical tubers (n = 197), and WM abnormalities (n = 82) than did T1-weighted (n = 58/85/33), proton density (n = 41/108/36), or T2-weighted (n = 48/121/46) SE images. The best C/N was obtained from Gd MT T1-weighted SE images in SENs and from MT T1-weighted SE images in other lesions. mMTRs of normal WM and GM were 36.43 and 29.42%, respectively. Cortical tubers and WM abnormalities had measured MTRs that were statistically equal to MTRs of GM in normal subjects (p < 0.005). MTRs of SENs showed lower mean (25.55%) and greater diversity (SD +/- 5.30), compared with MTRs of other lesions and normal GM and WM. One SEN with MTR of 20.72% was pathologically confirmed to be subependymal giant cell astrocytoma (SGCA). Nine SENs had measured MTR below 20.72% and six nodules among these were located in the region of the foramen of Monro, which is the characteristic location of SGCA.
MTI may be effective in detecting all cranial lesions of TS. MTR may increase the specificity of MRI because it can differentiate the histopathologic subtypes and track and evolution of SEN into SGCA.
我们的目标是评估磁化传递成像（MTI）的有效性以及磁化传递率（MTR）在结节性硬化症（TS）中的作用。
对10例TS患者在钆增强前后获取有/无饱和脉冲的T2加权和T1加权SE图像。比较在T1加权、质子密度加权、T2加权和MT T1加权SE图像上检测到的室管膜下结节（SEN）、皮质结节和白质（WM）异常的数量。计算T1加权、MT T1加权、钆增强T1加权和钆增强MT T1加权SE图像上的对比噪声比（C/N）以及每组饱和/非饱和图像上每个病变的MTR（1-Msat/MO）。还获取了7名正常志愿者白质和灰质的平均MTR（mMTR）。
MT T1加权SE图像总能显示出常规MRI上所见的所有病变，并且与T1加权（n = 58/85/33）、质子密度加权（n = 41/108/36）或T2加权（n = 48/121/46）SE图像相比，能显示出更多的SEN（n = 80）、皮质结节（n = 197）和WM异常（n = 82）。在SEN中，钆增强MT T1加权SE图像的C/N最佳，在其他病变中，MT T1加权SE图像的C/N最佳。正常WM和GM的mMTR分别为36.43%和29.42%。皮质结节和WM异常的测量MTR在统计学上与正常受试者GM的MTR相等（p < 0.005）。与其他病变以及正常GM和WM的MTR相比，SEN的MTR平均较低（25.55%）且差异较大（标准差±5.30）。一个MTR为20.72%的SEN经病理证实为室管膜下巨细胞星形细胞瘤（SGCA）。9个SEN的测量MTR低于20.72%，其中6个结节位于孟氏孔区域，这是SGCA的特征性位置。
MTI可能对检测TS的所有颅脑病变有效。MTR可能会提高MRI的特异性，因为它可以区分组织病理学亚型，并追踪SEN向SGCA的演变。
