目的:使用长重复时间(TR)和恒定翻转角(CFA)评估三维流体衰减反转恢复(3D-FLAIR)序列,以区分体模研究中的外淋巴和内淋巴,和患者研究中未增强的内淋巴积液(EH)成像。
方法:三种溶液中离子和蛋白质浓度相似,内淋巴,外淋巴虫,使用不同的TR(10,000、16,000和20,000ms)制备可变翻转角(VFA)3D-FLAIR(TR10,000ms)和CFA(120°)3D-FLAIR的脑脊液。52例可能或明确的梅尼埃病患者使用长TR(20,000ms)和4h延迟增强CFA(120°)3D-FLAIR(TR16,000ms)接受了未增强的CFA(120°)3D-FLAIR。图像质量,信噪比(SNR),并对它们的对比噪声比(CNR)进行了比较。分析了它们之间在评估EH程度方面的一致性。
结果:在幻影研究中,VFA3D-FLAIR(TR10,000ms)和CFA3D-FLAIR(TR10,000、16,000和20,000ms)的外淋巴和内淋巴样本之间的CNR分别为6.66±1.30、17.90±2.76、23.87±3.09和28.22±3.15(p<0.001)。在病人研究中,平均得分(3.65±0.48vs.4.19±0.40),信噪比(34.56±9.80vs.51.40±11.27),和CNR(30.66±10.55vs.未增强的3D-FLAIR的45.08±12.27)低于增强的3D-FLAIR(p<0.001)。对两个序列的评估在耳蜗和前庭中显示出极好的一致性(Kappa值:0.898和0.909)。
结论:使用长TR的CFA3D-FLAIR序列可以高精度地用于未增强的EH成像。
结论:内淋巴积水的非增强成像对患者的诊断和随访具有重要价值。尤其是那些无法接受对比增强MRI的患者。
结论:离子和蛋白质浓度差异可用于在MRI上区分内淋巴和外淋巴。内淋巴和外淋巴样品可以在此3D-FLAIR序列上进行体外分化。这种未增强的3D-FLAIR序列与增强的恒定翻转角3D-FLAIR序列非常吻合。
OBJECTIVE: To evaluate a three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequence using a long repetition time (TR) and constant flip angle (CFA) in differentiating between perilymph and endolymph in a phantom study, and unenhanced endolymphatic hydrops (EH) imaging in a patient study.
METHODS: Three solutions in similar ion and protein concentrations with endolymph, perilymph, and cerebrospinal fluid were prepared for variable flip angle (VFA) 3D-FLAIR (TR 10,000 ms) and CFA (120°) 3D-FLAIR using different TR (10,000, 16,000, and 20,000 ms). Fifty-two patients with probable or definite Meniere\'s disease received unenhanced CFA (120°) 3D-FLAIR using a long TR (20,000 ms) and 4-h-delay enhanced CFA (120°) 3D-FLAIR (TR 16,000 ms). Image quality, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of them were compared. Agreement in the evaluation of the EH degree between them was analyzed.
RESULTS: In the phantom study, CNRs between perilymphatic and endolymphatic samples of VFA 3D-FLAIR (TR 10,000 ms) and CFA 3D-FLAIR (TR 10,000, 16,000, and 20,000 ms) were 6.66 ± 1.30, 17.90 ± 2.76, 23.87 ± 3.09, and 28.22 ± 3.15 (p < 0.001). In patient study, average score (3.65 ± 0.48 vs. 4.19 ± 0.40), SNR (34.56 ± 9.80 vs. 51.40 ± 11.27), and CNR (30.66 ± 10.55 vs. 45.08 ± 12.27) of unenhanced 3D-FLAIR were lower than enhanced 3D-FLAIR (p < 0.001). Evaluations of the two sequences showed excellent agreement in the cochlear and vestibule (Kappa value: 0.898 and 0.909).
CONCLUSIONS: The CFA 3D-FLAIR sequence using a long TR could be used in unenhanced EH imaging with high accuracy.
CONCLUSIONS: Unenhanced imaging of endolymphatic hydrops is valuable in the diagnosis and follow-up of patients, especially those who cannot receive contrast-enhanced MRI.
CONCLUSIONS: Ion and protein concentration differences can be utilized in differentiating endolymph and perilymph on MRI. Endolymphatic and perilymphatic samples could be differentiated in vitro on this 3D-FLAIR sequence. This unenhanced 3D-FLAIR sequence is in excellent agreement with the enhanced constant flip angle 3D-FLAIR sequence.