磁共振快速增强扫描在脑肿瘤术前影像评估中的价值

doi:10.3969/j.issn.1009-976X.2025.05.007

摘要/Abstract

摘要： 目的探讨降低信号平均次数（NSA）以缩短脑肿瘤患者对比增强MRI扫描时间的可行性。方法回顾性分析2015年3月至2024年10月期间在中山大学孙逸仙纪念医院因临床怀疑脑肿瘤而行颅脑MRI增强扫描的46例患者的影像资料,对每例患者,比较其NSA=1和NSA=2时两个对比增强横断位T1加权序列所显示的病灶数量、信噪比（SNR）和对比噪声比（CNR）,以及两个序列的整体图像质量和病灶边界的清晰度（主观评分）。结果 NSA=2的横断位增强序列的信噪比（SNR）、对比噪声比（CNR）和整体图像质量评分分别为310.78±248.05、112.80±151.63和4.74±0.58,而NSA=1的横断位增强序列对应的值分别为237.40±159.74、89.29±110.18和4.5±0.59,统计结果显示,NSA=2序列的SNR（P<0.001）、CNR（P=0.002）和整体图像质量评分（P=0.028）均显著高于NSA=1序列。NSA=2和NSA=1时两组对比增强序列所显示的病灶数量评分（4.67±0.56 vs. 4.67±0.56,P=0.564）和病灶边界评分（4.67±0.56 vs. 4.67±0.56,P=1.000）均无统计学差异。结论将对比增强序列的NSA由2减为1可显著缩短扫描时间,并且诊断效能并未降低。因此降低信号平均次数在脑肿瘤患者的对比增强MRI扫描中具有可行性。

关键词: 脑肿瘤, 对比增强磁共振检查, 信号平均次数, 扫描时间

Abstract: Objective To explore the feasibility of reducing the number of signal averages （NSA） to shorten MRI scanning time in patients with brain tumors. Methods Imaging data from 46 patients who were suspected of brain tumors and underwent contrast-enhanced brain MRI scans at Sun Yat-sen Memorial Hospital of Sun Yat-sen University were retrospectively analyzed between March 2015 and October 2024. The number of lesions detected, signal-to-noise ratio （SNR）, contrast-to-noise ratio （CNR）, overall image quality, and subjective scores of lesion boundaries were compared between the contrast-enhanced axial T1-weighted sequences with NSA=1 and those with NSA=2 for each patient. Results The SNRs, CNRs, and overall image quality scores of the contrast-enhanced sequence with NSA=2 were 310.78± 248.05, 112.80± 151.63, and 4.74± 0.58, respectively. In contrast, those of the contrast-enhanced sequence with NSA=1 were 237.40± 159.74, 89.29± 110.18, and 4.5± 0.59, respectively. The SNRs, CNRs, and overall image quality scores of the sequence were all significantly higher than the latter （P< 0.001, P=0.002, and P=0.028, respectively）. There were no statistically significant differences in the number of lesions detected or lesion boundary scores （both were 4.67± 0.56） between the contrast-enhanced sequences with NSA=2 and those with NSA=1 （P=0.564 and P=1.000, respectively）. Conclusion Reducing NSA of the contrast-enhanced sequence from 2 to 1 significantly shortened scanning time while maintaining the samediagnostic performance. Thus, reducing NSA of the contrast-enhanced sequence from 2 to 1 to shorten the scanning time of brain tumor patients is feasible.

Key words: brain neoplasm, contrast-enhanced magnetic resonance imaging, number of signal averaged, scanning time

中图分类号:

王智慧, 李永, 白志强. 磁共振快速增强扫描在脑肿瘤术前影像评估中的价值[J]. 岭南现代临床外科, 2025, 25(05): 325-329.

WANG Zhi-hui, LI Yong, BAI Zhi-qiang. The value of rapid contrast ⁃ enhanced MRI in the preoperative imaging evaluation of brain tumors[J]. Lingnan Modern Clinics In Surgery, 2025, 25(05): 325-329.

参考文献

[1] Sung H, Ferlay J, Siegel RL, et al.Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249.
[2] Zheng RS, Chen R, Han BF, et al.[Cancer incidence and mortality in China, 2022][J]. Zhonghua Zhong Liu Za Zhi, 2024, 46(3): 221-231.
[3] Lau R, Gutierrez-Valencia E, Santiago A, et al.Surgical Resection Followed by Stereotactic Radiosurgery (S+SRS) Versus SRS Alone for Large Posterior Fossa Brain Metastases: A Comparative Analysis of Outcomes and Factors Guiding Treatment Modality Selection[J]. Brain Sci, 2024, 14(11): 1059.
[4] 国家卫生健康委员会医政医管局, 中国抗癌协会脑胶质瘤专业委员会, 中国医师协会脑胶质瘤专业委员会. 脑胶质瘤诊疗指南(2022版)[J]. 中华神经外科杂志, 2022, 38(8): 757-777.
[5] 石远凯, 孙燕, 于金明, 等. 中国肺癌脑转移诊治专家共识(2017年版)[J]. 中国肺癌杂志, 2017, 20(1): 1-13.
[6] Essig M, Anzalone N, Combs SE, et al.MR imaging of neoplastic central nervous system lesions: review and recommendations for current practice[J]. AJNR Am J Neuroradiol, 2012, 33(5): 803-817.
[7] Link TM, Patel R.The need for short MRI examinations: A musculoskeletal perspective[J]. J Magn Reson Imaging, 2019, 49(7): e49-e50.
[8] Ellingson BM, Bendszus M, Boxerman J, et al.Consensus recommendations for a standardized Brain Tumor Imaging Protocol in clinical trials[J]. Neuro Oncol, 2015, 17(9): 1188-1198.
[9] Fan B, Li M, Wang X, et al.Diagnostic value of gadobutrol versus gadopentetate dimeglumine in enhanced MRI of brain metastases[J]. J Magn Reson Imaging, 2017, 45(6): 1827-1834.
[10] Saini J, Gupta PK, Sahoo P, et al.Differentiation of grade II/III and grade IV glioma by combining “T1 contrast-enhanced brain perfusion imaging” and susceptibility-weighted quantitative imaging[J]. Neuroradiology, 2018, 60(1): 43-50.
[11] Attenberger UI, Runge VM, Morelli JN, et al.Evaluation of gadobutrol, a macrocyclic, nonionic gadolinium chelate in a brain glioma model: comparison with gadoterate meglumine and gadopentetate dimeglumine at 1.5 T, combined with an assessment of field strength dependence, specifically 1.5 versus 3 T[J]. J Magn Reson Imaging, 2010, 31(3): 549-555.
[12] Jeon J, Choi JW, Roh HG, et al.Effect of imaging time in the magnetic resonance detection of intracerebral metastases using single dose gadobutrol[J]. Korean J Radiol, 2014, 15(1): 145-150.
[13] Koo TK, Li MY.A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research[J]. J Chiropr Med, 2016, 15(2): 155-163.
[14] 康立丽, 卢广文, 余晓锷, 等. MRI扫描参数与信噪比关系的实验研究[J]. 中华放射学杂志, 2003, (3):33-35.
[15] Chiang CW, Lin SY, Cho KH, et al.Effects of signal averaging, gradient encoding scheme, and spatial resolution on diffusion kurtosis imaging: An empirical study using 7T MRI[J]. J Magn Reson Imaging, 2019, 50(5):1593-1603.
[16] Dietrich O, Raya JG, Reeder SB, et al.Measurement of signal-to-noise ratios in MR images: influence of multichannel coils, parallel imaging, and reconstruction filters[J]. J Magn Reson Imaging, 2007, 26(2): 375-385.
[17] 翟艳慧, 孙楠楠, 王君鑫, 等. 3.0 T MR胃癌患者IVIM-DWI序列参数优化的初步研究[J]. 磁共振成像, 2021, 12(2): 34-37.
[18] Heverhagen JT.Noise measurement and estimation in MR imaging experiments[J]. Radiology, 2007, 245(3): 638-639.
[19] 李文俊, 冯菲菲. 不同NEX的零回波时间序列在颅底骨质中的应用探索[J]. 医学理论与实践, 2023, 36(20): 3526-3528.
[20] 李希茂, 陶黎, 蔡焰, 等. 颅内血管壁成像中MSDE序列的参数优化研究[J]. 磁共振成像, 2022, 13(7): 112-115.
[21] Hamasaki H, Shirasaka T, Ushijima Y, et al.Improvement of Image Quality Using Hybrid Iterative Reconstruction with Noise Power Spectrum Model in Computed Tomography During Hepatic Arteriography[J]. J Belg Soc Radiol, 2021, 105(1): 43.
[22] 康立丽, 卢广文. 部分MR参数对信噪比影响实验研究[J]. 实用放射学杂志, 2003, (11):971-973.
[23] Oliveira AC, Filipe HAL, Geraldes CFGC, et al.Interaction of MRI Contrast Agent [Gd(DOTA)]- with Lipid Membranes: A Molecular Dynamics Study[J]. Inorg Chem, 2024, 63(24): 10897-10914.
[24] 陆洋, 柏根基. 定量动态增强磁共振成像及其在前列腺癌诊断和治疗中的研究进展[J]. 磁共振成像, 2015, 6(10): 796-800.
[25] 金征宇, 薛华丹. 医学放射诊断学新进展[J]. 协和医学杂志, 2011, 2(3): 197-199.