三維多回波聚合梯度回波序列在腰骶叢成像中的初步應用

摘要：目的" 探討3D多回波聚合梯度回波序列（3D GEMEC）在腰骶叢神經成像中的應用價值。 方法" 回顧性分析2022年8～9月六安市人民醫院以腰腿疼為主訴的32例住院患者的影像學資料，男15例，女17例，年齡28～78（60.1±15.8）歲。在不同1.5T平臺上分別完成腰骶叢3D GEMEC序列和三維T2加權快速梯度回波（3D T2 FFE）序列，比較兩種序列腰骶叢神經的信噪比、對比噪聲比和主觀顯示效果。結果" 3D GEMEC序列腰骶叢神經的信噪比、對比噪聲比以及主觀顯示效果與3D T2 FFE序列的差異均無統計學意義（P=0.250、0.146、0.083）。結論" 3D GEMEC序列可以清晰地顯示腰骶叢神經的解剖結構并抑制背景信號，在腰骶叢神經病變的診斷方面具有一定的臨床應用前景。

關鍵詞：腰骶叢神經；磁共振成像技術；3D多回波聚合梯度回波序列；信噪比；對比噪聲比

Preliminary application of 3D gradient echo with multi-echo combination sequence in lumbosacral plexus imaging

LI Yunyun， PENG Chuanyong， WU Zongshan， XU Qilan， CHEN Qi

Department of Medical Imaging， Lu'an People's Hospital， Lu'an 237005， China

Abstract： Objective To investigate the application value of 3D gradient echo with multi-echo combination （3D GEMEC） sequence in lumbosacral plexus imaging. Methods The imaging data of 32 inpatients who were admitted to Lu'an People's Hospital due to low back and leg pain from August to September 2022 were analyzed retrospectively， including 15 males and 17 females， with age ranging from 28 to 78 （60.1±15.8） years old. Lumbosacral plexus 3D GEMEC sequence and 3D T2 fast field echo （3D T2 FFE） sequence were performed on different 1.5T platforms， respectively. Signal-to-noise ratios， contrast-to-noise ratios and subjective display effects of lumbosacral plexus were compared between the two kinds of sequences. Results There was no statistically significant difference in signal-to-noise ratio， contrast-to-noise ratio and subjective display effect of lumbosacral plexus between 3D GEMEC sequence and 3D T2 FFE sequence （P=0.250， 0.146， 0.083）. Conclusion 3D GEMEC sequence can clearly demonstrate the anatomical structure of lumbosacral plexus and suppress background signals. It has prospects in the diagnosis of lumbosacral plexus neuropathy.

Keywords： lumbosacral plexus; magnetic resonance imaging; 3D gradient echo with multi-echo combination; signal-to-noise ratio; contrast-to-noise ratio

腰骶部病變常累及腰骶叢神經、產生相應臨床癥狀，如神經痛、下肢功能障礙等，MR具有良好的軟組織對比能力以及多平面成像優勢，是目前顯示和診斷腰骶叢神經病變的首選影像學檢查方法［1］ 。由于腰骶叢神經在解剖學上走行迂曲、毗鄰復雜，MR常規序列掃描難以清晰地顯示其完整形態［2］ 。有學者于1992年首先報道了MR神經成像［3］ ，隨著MRI軟硬件技術的發展三維梯度回波序列［4］ 、自旋回波序列[5]和擴散張量成像［6］ 等多種序列和后處理技術被用于MR外周神經成像［7］ ，均取得了一定的臨床應用價值。已有研究將不同的成像技術進行對比［5， 8， 9］ ，但結論不一。目前國內外腰骶叢神經成像的研究均在進口高端MRI設備上進行，雖然國產影像設備裝機量越來越多，但該成像技術在國產磁共振設備上的研究未見報道。……