1.5T磁共振脂肪抑制技術於急性胸腰椎骨折之應用

Application of 1.5TeslaMR Fat Suppression Technique in Acute Thoracolumbar Spine Compression Fracture

陳文昌(Wen-Chang Chen)；王士崇(Shih-Chorng Wang)；林秋湧(Chiu-Yung Lin)；陳志峰(Chih-Feng Chen)；林偉銘(Wei-Ming Lin)

1.5T磁共振 ； 急性胸腰椎骨折 ； 頻譜預飽和反轉恢復技術 ； 短時間反轉恢復 ； 1.5 Tesla magnetic resonance ； acute thoracolumbar compression spine ； spectral presaturation with inversion recovery ； short TI inversion recovery

中華放射線技術學雜誌

39卷3期（2015 / 09 / 01）

130 - 136

繁體中文

本研究的目的是要探討1.5T磁共振下對急性胸腰椎骨折患者，在使用脂肪抑制技術之頻譜預飽與短時間反轉恢復，何者較能代替施打釓顯影劑後之影像。研究由三位觀測者對施打造影劑前之橫向弛緩頻譜預飽矢狀切面、橫向弛緩短時間反轉恢復矢狀切面及施打造影劑後縱向弛緩頻譜預飽矢狀切面三組影像，量測其急性骨折高訊號區域面積，經成對樣本T檢定分析施打造顯劑前橫向弛緩頻譜預飽矢狀切面與施打造顯劑後縱向弛緩頻譜預飽矢狀切面，其雙尾概率(p=0.082)，顯示此兩組急性骨折高訊號區面積量測結果並沒有顯著性之差異；而在施打造顯劑前橫向弛緩短時間反轉恢復矢狀切面與施打造顯劑後縱向弛緩頻譜預飽矢狀切面，其雙尾概率(p＜0.001)，顯示此兩組是有顯著性差異。在影像品質重要性問卷評分，發現施打造影劑前橫向弛緩頻譜預飽矢狀切面影像品質重要性問卷平均分數為4.303，施打造影劑前橫向弛緩短時間反轉恢復矢狀切面影像品質重要性問卷平均分數為3.333，而施打造影劑後縱向弛緩頻譜預飽矢狀切面影像之品質重要性問卷平均分數為4.515。顯示施打造影劑前橫向弛緩頻譜預飽矢狀切面與施打造影劑後縱向弛緩頻譜預飽矢狀切面影像，在臨床影像品質重要性上是一樣重要。因此研究建議臨床檢查遇到急性或慢性腎功能不全病患，有發生腎性全身纖維化症疑慮下，建議在1.5T 磁共振下，可使用橫向弛緩頻譜預飽矢狀切面影像來取代需施打含釓的化合物縱向弛緩頻譜預飽矢狀切面影像，以降低施打顯影劑所產生併發症之風險，亦能達到臨床準確診斷之效果。

The purpose of this study was to investigate under 1.5 Tesla magnetic resonance (MR) for acute thoracolumbar compression spine patients, the use of fat suppression technique of spectral presaturation with inversion recovery (SPIR) and short TI (inversion time) inversion recovery (STIR), whichever is more able to fight instead of applying gadolinium developer after the image. The studies was assayed by the pre-contrast T2WI (T2weighted image)-SPIR-SAG (sagittal plane), T2WI-STIR-SAG and post-contrast T1WI (T1weighted image)-SPIR-SAG measuring their high signal area of acute fracture. By paired-T test analysis pre-contrast T2WI-SPIR-SAG and post-contrast T1WI-SPIR-SAG (p=0.082), it shows no significant differences comparing with two acute compression spine high signal areas measurement results. In the pre-contrast T2WI-STIR-SAG and post-contrast T1WI-SPIR-SAG (p＜0.001), the two groups was presented with significant differences. Questionnaire rating on the importance of image quality found that pre-contrast T2WI-SPIR-SAG averages and post-contrast T1WI-SPIR-SAG averages are 4.303, 3.333 and 4.515 respectively. To show pre-contrast T2WI-SPIR-SAG and post-contrast T1WI-SPIR-SAG is just as important on the importance of clinical image quality. Therefore, the clinical examination findings encountered renal insufficiency patients will induce a nephrogenic systemic fibrosis due to gadolinium-containing compounds. Suggest under the 1.5T MRI can be used T2WI-SPIR-SAG tosubstitute injections gadolinium post-contrast T1WI-SPIR-SAG. In order to reduce the risk of complications of the developer applied to fight generated, can also achieve an accurate diagnosis of the clinical effect.