Pui M H, Goh P S, Choo H F, Fok E C
Department of Radiology, National University Hospital, Singapore.
Australas Radiol. 1997 May;41(2):99-102.
Fat-saturation (FS) pulse sequences can improve the detection of musculoskeletal lesions. We prospectively compared contrast-enhanced T1-weighted FS spin-echo (SE) images, T2-weighted FS fast spin-echo (FSE) images and inversion recovery (IR) FSE images to determine if any of these three pulse sequences is superior for depicting bone marrow and soft tissue lesions. T1-weighted FS-SE images (400-680/10-20 [TR/TE]) after intravenous injection of gadolinium-diethylenetriaminepentaacetic acid (DTPA), T2-weighted FS-FSE (2400-4200/96-112) and IR-FSE (3700-6000/12-14/170 [TR/TE/TI]) images were obtained with a 1.5-T magnet system in 35 patients. The visibility, margination and extent of 37 bone marrow and 67 soft tissue lesions, image uniformity, susceptibility and motion artefacts were qualitatively analysed by four radiologists. The number and size of lesions detected, the mean lesion signal-to-noise ration (S/N) and contrast-to-noise ratio (C/N) were also statistically compared. More bone and soft-tissue lesions were detected on the IR-FSE and T2-weighted FS-FSE than the T1-weighted FS-SE images. The IR-FSE images were significantly better than the T2-weighted FS-FSE and T1-weighted FS-SE images for bone marrow lesions conspicuity (P < 0.01). The soft-tissue lesions were also more conspicuous on the IR-FSE and T2-weighted FS-FSE images than on the T1-weighted FS-SE images (P < 0.005). The lesion extent and image quality were similar on all three sequences while motion artefacts were most severe on the IR-FSE and least severe on the T1-weighted FS-SE images (P < 0.001). Fat saturation was maximal on the IR-FSE images, resulting in a significantly higher mean C/N of bone marrow lesions. The mean C/N of soft-tissue lesions was higher on the T2-weighted FS-FSE images although the differences were not significant. The T2-weighted FS-FSE and IR-FSE sequences are superior to the contrast-enhanced T1-weighted FS-SE sequence for depicting musculoskeletal lesions. Bone marrow lesion conspicuity is greater on the IR-FSE images, with comparable scan time and image quality but more motion artifacts.
脂肪饱和（FS）脉冲序列可提高肌肉骨骼病变的检出率。我们前瞻性地比较了对比增强T1加权FS自旋回波（SE）图像、T2加权FS快速自旋回波（FSE）图像和反转恢复（IR）FSE图像，以确定这三种脉冲序列中的任何一种在描绘骨髓和软组织病变方面是否更具优势。在35例患者中，使用1.5-T磁体系统获得静脉注射钆-二乙三胺五乙酸（DTPA）后的T1加权FS-SE图像（400-680/10-20 [TR/TE]）、T2加权FS-FSE（2400-4200/96-112）和IR-FSE（3700-6000/12-14/170 [TR/TE/TI]）图像。由四位放射科医生对37处骨髓病变和67处软组织病变的可见性、边界和范围、图像均匀性、敏感性和运动伪影进行定性分析。还对检测到的病变数量和大小、平均病变信噪比（S/N）和对比噪声比（C/N）进行了统计学比较。与T1加权FS-SE图像相比，IR-FSE和T2加权FS-FSE图像上检测到的骨和软组织病变更多。对于骨髓病变的清晰度，IR-FSE图像明显优于T2加权FS-FSE和T1加权FS-SE图像（P < 0.01）。IR-FSE和T2加权FS-FSE图像上的软组织病变也比T1加权FS-SE图像上更明显（P < 0.005）。所有三种序列上的病变范围和图像质量相似，而IR-FSE上的运动伪影最严重，T1加权FS-SE图像上最不严重（P < 0.001）。IR-FSE图像上的脂肪饱和最大，导致骨髓病变的平均C/N显著更高。T2加权FS-FSE图像上软组织病变的平均C/N更高，尽管差异不显著。在描绘肌肉骨骼病变方面，T2加权FS-FSE和IR-FSE序列优于对比增强T1加权FS-SE序列。IR-FSE图像上骨髓病变的清晰度更高，扫描时间和图像质量相当，但运动伪影更多。
