吞咽过程动态MRI的可行性探讨

The feasibility of magnetic resonance imaging of the dynamic swallowing

  • 摘要:
    目的 比较不同磁共振序列的扫描时间和图像质量,探讨应用其进行吞咽过程动态扫描,为临床提供直观、有效的咽部疾病诊断和治疗依据的可行性。
    方法 在GE 3.0T MRI系统上选用稳态采集快速成像(FIESTA)和快速梯度回波(Fast GRE)序列,并结合阵列空间敏感性编码技术(ASSET),对20例无自觉吞咽困难患者的咽部进行吞咽过程的单层矢状位动态快速扫描,分别连续采集60幅图像,由3位有经验的MRI医师采用双盲法,对所获得的全部图像分别以优、中、劣3种等级进行图像质量目测评价。
    结果 其他扫描参数相同时,FIESTA、Fast GRE、FIESTA+ASSET和Fast GRE+ASSET序列的扫描时间分别为:54 s、28 s、49 s和25 s;Fast GRE+ASSET序列的扫描时间最短;FIESTA、Fast GRE、FIESTA+ASSET和Fast GRE+ASSET序列的图像质量评价的总分值分别44、52、52和56;Fast GRE+ASSET序列获得的图像质量最佳。
    结论 在GE 3.0T MRI系统上用Fast GRE+ASSET序列进行吞咽动态矢状位成像,咽部结构显示较好,动态电影图像上吞咽过程显示清晰,具有为临床提供更直观、有效的诊断依据的可行性。

     

    Abstract:
    Objective To offer some visual and valuable clinical bases for the pharynx disease diagnosis and treatment by comparing the influence of different scanning sequences on the image quality and scanning time, and studying the application to the dynamic swallowing MRI scanning.
    Methods The dynamic swallowing scanning of pharyngeal was performed on 20 nasopharyngeal carcinoma patients without deglutition disorders through GE 3.0 MRI system with fast imaging employing steady state acquisition (FIESTA) and fast gradient recalled echo (Fast GRE) sequences, and combined with the array spatial sensitivity encoding technique(ASSET), which accelerating factors was 2.0 ph, and sixty dynamic images were acquired sequentially. The image quality was graded into three classes: excellent, favorable and poor, which were visually assessed by three senior MRI physician using double-blinded method. The quantitative data were analyzed statistically with the SPSS13.0 software.
    Results Under the same parameters, the scanning time with FIESTA, FIESTA+ASSET, Fast GRE and Fast GREA+ASSET sequences were 54 s, 28 s, 49 s and 25 s respectively. The number of excellent images with the four sequences were 44, 52, 52 and 56 respectively. The scanning time was the shortest and the image quality was the best with Fast GRE+ASSET sequence.
    Conclusions The dynamic imaging of swallowing in sagittal view was achieved with Fast GRE+ASSET sequence on GE 3.0T MRI system. It could present status of the pharynx well, and the soft tissue of swallowing was showed clearly in the dynamic images. These will provide visual and effective evidence for clinical diagnosis and treatment.

     

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