Pozzi Mucelli R, Cova M, Shariat-Razavi I, Zucconi F, Ukmar M, Longo R
Istituto di Radiologia, Università di Trieste.
Radiol Med. 1997 May;93(5):504-9.
Thirty-two patients affected with skeletal conditions were examined with MRI using Short TI Inversion Recovery sequence and Spectral Presaturation with Inversion Recovery (SPIR) sequence as well as Spin-Echo (SE) T1-weighted sequence and Fast Spin-Echo (FSE) T2-weighted sequence to compare their value in the assessment of skeletal lesions. SPIR sequence was performed after intravenous injection of Gd-DTPA. The lesions included primary bone tumors (10 cases: 1 osteosarcoma, 1 periosteal sarcoma, 1 Ewing's sarcoma, 1 chondrosarcoma, 2 non-ossifying fibromas, 1 chondroma, 1 chondromyxoid fibroma, 1 desmoplastic fibroma and 1 bone cyst), metastases (7 cases: 3 prostate, 3 breast, 1 lung-squamous cell carcinoma), infections (12 cases: 9 osteomyelitis, 3 spondylodiscitis), sacroiliitis (1 case) and posttraumatic bone bruise (2 cases of bone marrow edema). The four sequences were compared by using both qualitative and quantitative evaluation. Qualitative evaluation showed that STIR sequence was better than SPIR sequence (performed with Gd-DTPA) for lesion conspicuity (p < .016) and for signal intensity uniformity (p < .03). Compared with SE T1 and FSE T2 sequences, fat-suppressed sequences were superior for conspicuity, margins, and extension of the lesions (range of p < .001-.017). Only SPIR with Gd-DTPA sequence, compared with SE T1 sequence for lesion conspicuity was not statistically significantly different. Quantitative evaluation showed statistically significant higher values of percent contrast (%C) and contrast-to-noise ratio (C/N) for STIR sequence compared with SPIR sequence (%C p < .004; C/N p < .040). This study suggests that STIR sequence and SE T1-weighted sequence provide high sensitivity in lesion detection and good anatomical definition. The use of a fat-suppressed sequence with Gd-DTPA can be useful for lesion characterization.
对32例患有骨骼疾病的患者进行了MRI检查，使用短TI反转恢复序列、频谱预饱和反转恢复（SPIR）序列以及自旋回波（SE）T1加权序列和快速自旋回波（FSE）T2加权序列，以比较它们在评估骨骼病变中的价值。SPIR序列在静脉注射钆喷酸葡胺（Gd-DTPA）后进行。病变包括原发性骨肿瘤（10例：1例骨肉瘤、1例骨膜肉瘤、1例尤因肉瘤、1例软骨肉瘤、2例非骨化性纤维瘤、1例软骨瘤、1例软骨黏液样纤维瘤、1例促纤维组织增生性纤维瘤和1例骨囊肿）、转移瘤（7例：3例前列腺癌、3例乳腺癌、1例肺鳞状细胞癌）、感染（12例：9例骨髓炎、3例脊椎间盘炎）、骶髂关节炎（1例）和创伤后骨挫伤（2例骨髓水肿）。通过定性和定量评估对这四个序列进行了比较。定性评估显示，短TI反转恢复（STIR）序列在病变显示度（p < 0.016）和信号强度均匀性方面优于SPIR序列（在注射Gd-DTPA后进行）（p < 0.03）。与SE T1和FSE T2序列相比，脂肪抑制序列在病变的显示度、边界和范围方面更具优势（p值范围为< 0.001 - 0.017）。仅注射Gd-DTPA的SPIR序列与SE T1序列相比，在病变显示度方面无统计学显著差异。定量评估显示，与SPIR序列相比，STIR序列的对比剂百分比（%C）和对比噪声比（C/N）具有统计学显著更高的值（%C p < 0.004；C/N p < 0.040）。本研究表明，STIR序列和SE T1加权序列在病变检测中具有高敏感性和良好的解剖学清晰度。使用注射Gd-DTPA的脂肪抑制序列有助于病变的特征性诊断。
