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中华妇幼临床医学杂志(电子版) ›› 2015, Vol. 11 ›› Issue (4) : 475 -479. doi: 10.3877/cma.j.issn.1673-5250.2015.04.009

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论著

磁共振成像T1加权反转恢复序列在评价婴儿颅脑发育中的应用
白万晶*(), 宁刚*(), 李学胜*()   
  1. 610041 成都,四川大学华西第二医院放射科
  • 收稿日期:2015-01-09 修回日期:2015-06-20 出版日期:2015-08-01
  • 通信作者: 白万晶, 宁刚, 李学胜

Application of MRI T1 weighted inversion recovery sequence in evaluation of brain development in infants

Wanjing Bai*(), Gang Ning*(), Xuesheng Li*()   

  1. Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
  • Received:2015-01-09 Revised:2015-06-20 Published:2015-08-01
  • Corresponding author: Wanjing Bai, Gang Ning, Xuesheng Li
引用本文:

白万晶, 宁刚, 李学胜. 磁共振成像T1加权反转恢复序列在评价婴儿颅脑发育中的应用[J/OL]. 中华妇幼临床医学杂志(电子版), 2015, 11(4): 475-479.

Wanjing Bai, Gang Ning, Xuesheng Li. Application of MRI T1 weighted inversion recovery sequence in evaluation of brain development in infants[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2015, 11(4): 475-479.

目的

探讨磁共振成像(MRI)采用T1加权反转恢复(T1WIR)序列在评价婴儿颅脑发育中的应用。

方法

选择2014年3月~6月在四川大学华西第二医院行颅脑MRI检查的28例婴儿为研究对象,对其采用T1WIR序列和T1加权自旋回波(T1WSE)序列进行颅脑轴位扫描(横断层扫描),评价婴儿颅脑发育情况。由2位放射科医师独立对所有MRI图像进行髓鞘形成清晰显示情况评分(0~3分),3分为能清晰显示髓鞘形成者。对评分结果进行一致性检验,计算Kappa值,并对评分结果进行秩和检验;计算2种序列灰白质对比率(CR)及相对于T1WSE序列的T1WIR序列灰、白质信号降低率;分别对2种序列CR及灰、白质信号降低率进行配对t检验。

结果

①2位放射科医师对MRI图像的髓鞘形成清晰显示情况评分结果存在一致性(u=7.887,P=0.000),并且具有相当满意的一致程度(Kappa值=0.792);本组28例婴儿采用T1WIR序列MRI图像的髓鞘形成清晰显示情况评分结果高于T1WSE序列,且差异有统计学意义(3分vs2分,Z=-3.64,P=0.000)。②T1WIR序列灰白质CR较T1WSE序列灰白质CR高,且差异有统计学意义[(0.26±0.06)vs(0.05±0.02),t=16.544,P=0.000];对T1WSE序列而言,T1WIR序列的灰质信号降低率较白质信号降低率低,且差异有统计学意义[(2.03±0.83)vs(2.25±1.26),t=-2.616,P=0.014]。

结论

采用T1WIR序列可取代常规T1WSE序列进行MRI成像,用于评价婴儿颅脑发育。

Objective

To explore the application of Magnetic Resonance Imaging(MRI) T1 weighted inversion recovery(T1WIR) sequence in evaluation of brain development in infants.

Methods

A total of 28 infants who accepted MRI examination of brain in West China Second University Hospital, Sichuan University from March to June 2014 were chosen as study subjects.Every infant was underwent both T1WIR and T1 weighted spin echo (T1WSE) sequence in brain transverse axial scanning to evaluate brain development.All MR images were evaluated and scored(0-3) about myelination by two roentgenologists independently.Images with score of 3 can clearly display myelination.Consistency test was made for the scores between these two roentgenologists.Kappa value was calculated and all scores were underwent rank sum test.Contrast ratio (CR) of grey matter-to-white matter was calculated in both T1WIR and T1WSE sequence.Intensity decreased ratio of T1WIR-to-T1WSE was also calculated in both grey matter and white matter.CR of the two sequences, intensity decreased ratios of grey matter and white matter were all underwent paired t-test.

Results

①MR image scores about myelination between the two doctors was consistent(u=7.887, P=0.000)and with a comparatively satisfactory consistent degree(Kappa value=0.792). MR image score about myelination of T1WIR sequence in 28 infants was higher than that of T1WSE sequence, and the difference was significantly(3 points vs 2 points, Z=3.64, P=0.000). ②CR of T1WIR sequence was higher than that of T1WSE sequence, and the difference was significantly[(0.26±0.06) vs (0.05±0.02), t=16.544, P=0.000]. According to T1WSE sequence, intensity decreased ratio of grey matter in T1WIR sequence was lower than that of white matter, and the difference was significantly[(2.03±0.83) vs (2.25±1.26), t=2.616, P=0.014].

Conclusion

T1WIR sequence of MRI can substitute T1WSE sequence in evaluation of brain development in infants.

图1 灰、白质信号强度测量部位(女性,2个月)注:白色箭头为左侧丘脑灰质ROI,大小为3.6 mm×3.6 mm;黑色箭头为左侧额叶白质ROI,大小为3.6 mm×3.6 mm
图2 2个月女婴颅脑MRI横断层扫描图像(图2A:T1WIR序列;图2B:TIWSE序列)注:图2A白色箭头所示为在白质的低信号背景中,高信号的髓鞘出现在内囊后肢、丘脑腹外侧核及视放射,脑龄为2个月左右,符合其生理年龄;图2B白色箭头所示为该患儿仅内囊后肢和视放射可见高信号髓鞘
图3 颅脑MRI横断层扫描T1WIR序列图像(图3A:女性,9 d;图3B:男性,5个月;图3C:男性,9个月)注:图3A白色箭头所示为仅内囊后肢、丘脑腹外侧核可见高信号髓鞘;图3B为实际年龄为5个月,但只能看见内囊后肢的高信号(白色箭头所示),其脑龄相当于1个月,为脑发育落后;图3C为髓鞘已完全形成,白质显示为较高信号
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