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目的与常规单次激发平面回波(Ss-EPI)弥散加权成像(DWI)比较,探讨读出方向分段采样平面回波(Rs-EPI)DWI序列在颅内占位性病变的临床应用价值。方法连续纳入临床诊断为颅内占位性病变的患者21例,采用SEIMENS Skyra 3.0T MRI及20通道的头颈联合线圈,行常规Ss-EPI DWI和Rs-EPI DWI序列扫描,由2名高年资影像诊断医师从对比噪声比(CNR)、信噪比(SNR)、伪影、图像整体质量及病变显示等方面进行评价分析。两种序列的图像质量比较采用非参数Wilcoxon符号秩和检验,2名阅片者之间一致性检测采用Kappa检验及组内相关系数(ICC)分析。结果 21例患者均成功完成两组序列扫描。Ss-EPI DWI序列的SNR、CNR(130.46±49.10,33.22±18.86)高于Rs-EPI DWI序列(71.58±30.43,17.92±18.72)(P均<0.05)。鼻窦旁、乳突气房旁、额窦旁Rs-EPI DWI畸变伪影(3.67±0.48,3.57±0.50,3.90±0.30)小于Ss-EPI DWI(2.10±0.10,2.33±0.58,2.80±0.60)(P均<0.05);Rs-EPI DWI病变显示优于Ss-EPI DWI(3.95±0.22vs.3.19±0.60,P<0.05);RsEPI DWI图像整体质量优于Ss-EPI DWI(3.86±0.86vs.2.71±0.46,P<0.05)。Rs-EPI DWI图像变形小于SsEPI DWI(0.016±0.021vs.0.037±0.069,P=0.00)。2名阅片者对两种序列的主观及客观评价一致性好[0.74≤Kappa值或ICC≤0.92]。结论 Rs-EPI DWI序列提高颅内占位性病变显示情况,降低了图像畸变伪影,可获得高分辨、高图像质量的弥散加权图像。
OBJECTIVE: To evaluate the clinical value of readout-oriented Ss-EPI DWI in detecting intracranial space-occupying lesions by using Ss-EPI DWI (Sequential Single Stimulation Plane Echocardiography) . Methods Twenty-one patients with clinically diagnosed intracranial space-occupying lesions were enrolled in this study. Sequential Ss-EPI DWI and Rs-EPI DWI were performed with SEIMENS Skyra 3.0T MRI and 20-channel head-and-neck co-coils. The imaging diagnostician evaluated and analyzed CNR, SNR, artifacts, overall image quality and lesion display. Non-parametric Wilcoxon signed-rank test was used to compare the image quality of the two sequences. Kappa test and ICC analysis were used to test the consistency of the two readers. Results All the 21 patients successfully completed two sets of sequential scanning. The SNR, CNR (130.46 ± 49.10, 33.22 ± 18.86) of Ss-EPI DWI sequences were higher than those of Rs-EPI DWI sequences (71.58 ± 30.43,17.92 ± 18.72) (all P <0.05). The Ss-EPI DWI (2.10 ± 0.10, 2.33 ± 0.58, 2.80 ± 0.60) artifacts were found near the paranasal sinuses and mastoid antrums in frontal sinusoids (3.67 ± 0.48,3.57 ± 0.50,3.90 ± 0.30) (P <0.05). The overall quality of RsEPI DWI was better than that of Ss-EPI DWI (3.86 ± 0.86 vs 3.95 ± 0.22 vs 3.19 ± 0.60, P <0.05) .2.71 ± 0.46, P <0.05). The deformation of Rs-EPI DWI images was smaller than that of SsEPI DWI (0.016 ± 0.021 vs. 0.037 ± 0.069, P = 0.00). Two reviewers had good subjective and objective evaluations of both sequences [0.74 ≤ Kappa value or ICC ≤ 0.92]. Conclusion The Rs-EPI DWI sequence can improve the display of intracranial space-occupying lesions and reduce the artifacts of image distortions. It can obtain diffusion-weighted images with high resolution and high image quality.