Cottier J P, Akoka S, Brunereau L, Sonier C B, Franconi F, Hommet C, Herbreteau D, Sirinelli D
Service de neuroradiologie, CHU Bretonneau Tours.
J Neuroradiol. 1998 Jul;25(2):129-35.
Assess three fat suppression sequences used to search for spinal metastases: TurboSTIR, phase contrast gradient-echo, and MISTEC-Chopper after gadolinium injection.
A prospective study was conducted in 10 patients with primary neoplasia. MIR sequences acquired (1 Tesla) were TurboSTIR, T1 spin-echo with and without gadolinium injection, phase contrast gradient-echo and M-Chop after gadolinium injection. Signal intensity in normal bone marrow, metastatic tissue, and subcutaneous fat as well as background noise was measured. Signal-to-noise (S/N) ratio was determined. Lesion borders, artefacts, and extent of detected lesions were determined quantitatively. Bone marrow signal intensity was also recorded.
S/N ratio was best with gradient-echo which identified well the borders of lesions within the hemopoietic marrow. For lesions located in high-fat marrow (as in post-radiation marrow), the high intensity signal of the lesion confounded with the fat signal. TurboSTIR gave effective fat signal suppression and was particularly useful for yellow marrow, less so for red marrow. This technique confounded cell proliferation with perilesional edema (enlarging lesion extention). In one case, this sequence did not detect a small lesion visible with the two other sequences. This sequence was sensitive to artefacts (especially vascular artefacts) which can produce false nodular images. M-Chop gave good suppression of vertebral fat tissue (better for yellow marrow) but subjective detection of lesions was more difficult.
The phase contrast gradient-echo sequence after gadlinium injection appeared to be the best sequence excepting cases of post-trauma (radiotherapy or chemotherapy) fat transformation of the marrow where the TurboSTIR sequence could be preferred.
评估三种用于寻找脊柱转移瘤的脂肪抑制序列：钆注射后的TurboSTIR序列、相位对比梯度回波序列和MISTEC-斩波序列。
对10例原发性肿瘤患者进行了一项前瞻性研究。采集的磁共振成像（1特斯拉）序列包括TurboSTIR序列、注射钆前后的T1自旋回波序列、相位对比梯度回波序列以及钆注射后的M-斩波序列。测量正常骨髓、转移组织、皮下脂肪以及背景噪声中的信号强度。测定信噪比。定量确定病变边界、伪影以及检测到的病变范围。同时记录骨髓信号强度。
梯度回波序列的信噪比最佳，能很好地识别造血骨髓内病变的边界。对于位于高脂骨髓（如放疗后骨髓）中的病变，病变的高强度信号与脂肪信号混淆。TurboSTIR序列能有效抑制脂肪信号，对黄骨髓特别有用，对红骨髓的效果稍差。该技术将细胞增殖与病变周围水肿（扩大病变范围）混淆。在1例病例中，该序列未检测到另外两个序列可见的小病变。该序列对伪影（尤其是血管伪影）敏感，可产生假结节图像。M-斩波序列能很好地抑制椎体脂肪组织（对黄骨髓效果更好），但病变的主观检测更困难。
钆注射后的相位对比梯度回波序列似乎是最佳序列，但骨髓发生创伤后（放疗或化疗）脂肪转化的情况除外，此时TurboSTIR序列可能更可取。
