快速智能磁共振技术在三叉神经MRI中的应用价值

Application value of intelligent quick magnetic resonance technology in trigeminal nerve magnetic resonance imaging

    摘要
  • 摘要:
    目的  探讨快速智能磁共振（IQMR）技术在血管压迫性三叉神经痛（TN）术前MRI中的应用价值。
    方法  收集2025年7月至2025年12月于天津医科大学总医院就诊的36例疑似血管压迫性TN患者男性6例、女性30例，年龄（63.8±9.4）岁的影像资料进行前瞻性随机对照试验研究。所有患者均行常规MRI和IQMR成像，比较常规MRI和IQMR成像的扫描时间、图像质量的主观评分、图像质量的客观评价指标及诊断效能。2组间比较采用配对Wilcoxon秩和检验，采用Cohen加权Kappa检验评估不同医师对图像质量主观评分的一致性。
    结果  IQMR成像的整体扫描时间（288 s）较常规MRI（449 s）缩短了35.86%。IQMR成像的横断面T2加权成像、横断面T1加权成像、三维稳态进动快速成像（3D-FIESTA）和三维时间飞跃（3D-TOF）序列的扫描时间较常规MRI分别缩短了14.29%、17.50%、46.58%、32.84%（48 s对56 s，33 s对40 s，117 s对219 s，90 s对134 s）。2名医师对常规MRI与IQMR成像图像质量主观评分的差异均有统计学意义（Z=3.46、2.83，均P<0.05）。2名医师对IQMR成像图像质量主观评分的Kappa值为0.898（95%CI：0.785~1.010，P<0.05），对常规MRI图像质量主观评分的Kappa值为0.900（95%CI：0.791~1.010，P<0.05），2名医师间主观评分的一致性优秀。IQMR成像中的3D-FIESTA、3D-TOF序列的信噪比神经、对比噪声比（CNR）神经-脑脊液、CNR动脉-脑脊液均明显高于常规MRI（Z=3.66~11.11，均P<0.01）。常规MRI和IQMR成像诊断神经与血管接触的灵敏度、特异度、准确率均分别为100%、100%、97.22%。
    结论  IQMR技术可在大幅缩短MRI扫描时间的同时，明显提高三叉神经成像的质量，为TN的术前评估提供精准的解剖学依据，具有重要的临床应用价值。

     

    Abstract:
    Objective  To explore the application value of intelligent quick magnetic resonance (IQMR) technology in the preoperative MRI of vascular compressive trigeminal neuralgia (TN).
    Methods Imaging data were collected from 36 patients with suspected vascular compressive TN treated in Tianjin Medical University General Hospital from July 2025 to December 2025 (6 males and 30 females, aged (63.8±9.4) years), and a prospective randomized controlled trial was conducted. All patients underwent conventional MRI and IQMR imaging. The scanning time, image quality subjective scores and objective evaluation indicators, and diagnostic efficacy of conventional MRI and IQMR imaging were compared. Wilcoxon rank sum test was used for the comparison between two groups, and Cohen weighted Kappa test was employed to evaluate the consistency of the subjective scores of image quality among different radiologists.
    Results  The overall scanning time of IQMR imaging (288 s) had shortened by 35.86% compared with that of conventional MRI (449 s). The scanning times of axial T2 weighted imaging, axial T1 weighted imaging, three-dimensional fast imaging employing steady state acquisition (3D-FIESTA) sequence, and the three-dimensional time-of-flight (3D-TOF) sequence of IQMR imaging had shortened by 14.29%, 17.50%, 46.58% and 32.84% (48 s vs. 56 s, 33 s vs. 40 s, 117 s vs. 219 s, 90 s vs. 134 s), respectively, compared with those of conventional MRI. Statistically significant differences in the subjective scores of image quality were observed between conventional MRI and IQMR imaging by two radiologists (Z=3.46, 2.83; both P<0.05). The Kappa value of the subjective scores of image quality for IQMR imaging by two radiologists was 0.898 (95%CI: 0.785–1.010, P<0.05) and that for conventional MRI was 0.900 (95%CI: 0.791–1.010, P<0.05). The consistency of subjective scores between two radiologists was excellent. The nerve signal-to-noise ratio, nerve-cerebrospinal fluid contrast-to-noise ratio (CNR), and artery-cerebrospinal fluid CNR of the 3D-FIESTA and 3D-TOF sequences in IQMR imaging were significantly higher than those in conventional MRI (Z=3.66–11.11, all P<0.01). The sensitivity, specificity, and accuracy of conventional MRI and IQMR imaging in the diagnosis of neurovascular contact were 100%, 100%, and 97.22%, respectively.
    Conclusions  IQMR technology can considerably shorten the MRI scanning time and significantly improve the quality of trigeminal nerve imaging, providing precise anatomical evidence for the preoperative evaluation of TN. Therefore, it has important clinical application value.

     

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