Bonél H, Helmberger T, Geiss H C, Steinborn M, Ritter M M, Reiser M
Institut for Radiological Diagnosis, Klinikum Grosshadern der Ludwigs-Maximilians-Universität, Munich, Germany.
MAGMA. 1998 Nov;7(1):1-8. doi: 10.1007/BF02592250.
OBJECTIVE/PATIENTS: To investigate the efficacy of standard sequences of a low field system for the detection of osteomyelitis, we tested T1wI pre and post i.v. contrast, T2w and fat suppressed IR sequences.
On the basis of clinical and laboratory evidence, pathology reports, and three phase granulocyte scintigraphy, osteomyelitis was diagnosed in 18 of 21 patients with Charcot's joints. A consecutive low and high field magnetic resonance (MR) scan confirmed osteomyelitic bone marrow changes in the same osseous regions. These 18 diabetic patients were then studied on a 0.2 Tesla dedicated MR system (Esaote ArtoScan) using T1wI (SE: relaxation time (TR) 520/echo time (TE) 24: axial and coronal) before and after i.v. application of 0.1 mmol/l Gd-DTPA/kg BW, T2w imaging (TSE: TR 3500/TE 80 or TR 2000/TE 120: axial), and fat suppressed inversion recovery (IR) imaging (short tau inversion recovery (STIR): TR 3000/TE 30/TI 80 or inversion recovery gradient echo (IRGE)/fat suppressed IRGE (GEFS): TR 1000/TE 16m 80: coronal).
The SE T1w sequence showed a significantly higher contrast-to-noise ratio (CNR) before administration of i.v. contrast. The TSE T2w pulse sequence demonstrated bone marrow changes superiorily utilizing a TE of 120 ms (CNR = 16.5+/-2.7 compared to 5.5+/-2.5 with TE = 80 ms). The IRGE showed a higher CNR than the standard STIR (CNR = 19.2+/-2.5 compared to 12.4+/-2.9).
Fat suppressed IRGE imaging and longer TE in T2w TSE sequences result in a significantly better CNR in osteomyelitis. This way, using optimized sequences, low field systems are apt to depict bone marrow changes in the course of osteomyelitis.
目的/患者：为研究低场系统标准序列对骨髓炎的检测效果，我们对静脉注射造影剂前后的T1加权成像（T1wI）、T2加权成像（T2w）以及脂肪抑制反转恢复序列（IR）进行了测试。
基于临床和实验室证据、病理报告以及三相粒细胞闪烁显像，21例夏科氏关节患者中有18例被诊断为骨髓炎。连续的低场和高场磁共振（MR）扫描证实了同一骨区域存在骨髓炎骨髓改变。然后，对这18例糖尿病患者使用0.2特斯拉专用MR系统（依索塔ArtoScan）进行研究，静脉注射0.1 mmol/l钆喷酸葡胺/千克体重前后进行T1wI（自旋回波：弛豫时间（TR）520/回波时间（TE）24：轴位和冠状位）、T2w成像（快速自旋回波：TR 3500/TE 80或TR 2000/TE 120：轴位）以及脂肪抑制反转恢复（IR）成像（短反转时间反转恢复（STIR）：TR 3000/TE 30/TI 80或反转恢复梯度回波（IRGE）/脂肪抑制IRGE（GEFS）：TR 1000/TE 16/TI 80：冠状位）。
自旋回波T1w序列在静脉注射造影剂前显示出显著更高的对比噪声比（CNR）。快速自旋回波T2w脉冲序列在使用TE为120 ms时能更好地显示骨髓改变（CNR = 16.5±2.7，而TE = 80 ms时为5.5±2.5）。IRGE显示出比标准STIR更高的CNR（CNR = 19.2±2.5，而标准STIR为12.4±2.9）。
脂肪抑制IRGE成像以及T2w快速自旋回波序列中更长的TE在骨髓炎中能产生显著更好的CNR。通过这种方式，使用优化序列，低场系统能够描绘骨髓炎病程中的骨髓改变。
