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中华肝脏外科手术学电子杂志

中华肝脏外科手术学电子杂志 ›› 2024, Vol. 13 ›› Issue (02) : 182 -188. doi: 10.3877/cma.j.issn.2095-3232.2024.02.011

临床研究

光梭成像及梯度自旋回波技术在MRCP应用中的优势
熊安妮1, 黄锦彬1, 汪昕荣1, 雷漫诗1, 邓锶锶1, 向青1, 孟占鳌1,†()   
  1. 1. 510630　广州，中山大学附属第三医院放射科
  • 收稿日期:2023-12-25 出版日期:2024-04-10
  • 通信作者: 孟占鳌

Advantages of constellation shuttling imaging and GRASE gradient- and spin-echo technique in the application of MRCP

Anni Xiong1, Jinbin Huang1, Xinrong Wang1, Manshi Lei1, Sisi Deng1, Qing Xiang1, Zhan'ao Meng1,†()   

  1. 1. Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
  • Received:2023-12-25 Published:2024-04-10
  • Corresponding author: Zhan'ao Meng
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熊安妮, 黄锦彬, 汪昕荣, 雷漫诗, 邓锶锶, 向青, 孟占鳌. 光梭成像及梯度自旋回波技术在MRCP应用中的优势[J]. 中华肝脏外科手术学电子杂志, 2024, 13(02): 182-188.

Anni Xiong, Jinbin Huang, Xinrong Wang, Manshi Lei, Sisi Deng, Qing Xiang, Zhan'ao Meng. Advantages of constellation shuttling imaging and GRASE gradient- and spin-echo technique in the application of MRCP[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(02): 182-188.

目的

探讨光梭成像（Ucs）及梯度自旋回波（GRASE）技术在MRCP应用中的价值。

方法

本研究对象为2022年11月至2022年12月在中山大学附属第三医院行MRCP检查的30例患者。其中男15例，女15例；平均年龄（52±17）岁。患者均签署知情同意书，符合医学伦理学规定。所有患者分别采用3种不同方案扫描：常规方案采用3D快速自旋回波技术结合并行采集、呼吸触发技术（RT）；Ucs方案采用3D-Ucs技术结合RT的MRCP；快速GRASE方案采用3D快速自旋回波序列结合GRASE和屏气技术。客观评价：胆总管的信噪比（SNR）、对比度（CR）以及对比噪声比（CNR）。主观评价：两名10年以上腹部MRI诊断经验的放射科医师采用盲法5分标准对胆胰管的导管可见性、运动伪影、背景抑制、图像清晰度、整体图像质量进行单独评分，最后取5个指标的平均分。同时记录数据采集时间。

结果

客观评价显示，Ucs方案组SNR中位数为13（9，18），明显高于常规方案组的8（5，11） （Z=3.73，P<0.05）；Ucs方案组CNR为18（14，25），明显高于常规方案组的12（7，15） （Z=3.61，P<0.05）。主观评价显示，对于呼吸均匀患者，Ucs组5个指标评分均明显高于其他两组（P<0.05）；对于呼吸紊乱患者，GRASE方案组导管可见性、运动伪影、背景抑制、图像整体质量指标评分均明显优于常规方案组（P<0.05）；两位医师有较好的一致性（κ>0.8，P<0.05）。对于呼吸均匀患者，Ucs方案组数据采集时间较常规方案组缩短19%。对于呼吸紊乱患者，GRASE方案组数据采集时间较常规方案组缩短近92%，较Ucs方案组缩短近90%。

结论

与常规扫描方案相比，对于呼吸均匀患者Ucs方案组图像质量和数据采集时间明显占优势；而对于呼吸紊乱患者，快速GRASE方案占优势。Ucs方案为主快速GRASE方案辅助的MRCP序列组合相比常规方案更加优化。

关键词: 磁共振胰胆管成像, 光梭成像, 压缩感知, 梯度自旋回波, 并行采集, 呼吸触发, 屏气
Objective

To evaluate the value of constellation shuttling imaging (Ucs) and gradient- and spin-echo (GRASE) technique in the application of magnetic resonance cholangiopancreatography (MRCP).

Methods

30 patients receiving MRCP in the Third Affiliated Hospital of Sun Yat-sen University from November 2022 to December 2022 were enrolled. Among them, 15 patients were male and 15 female, aged (52±17) years on average. The informed consents of all patients were obtained and the local ethical committee approval was received. All patients received 3 different scanning protocols. Conventional scanning was conducted using 3D fast spin-echo (FSE) technique combined with parallel acquisition and respiratory-triggered (RT) technique. Ucs was performed using 3D-Ucs technique combined with MRCP using RT technique. Fast GRASE was delivered by using 3D FSE sequence combined with GRASE and breath-hold technique. Objective evaluation indexes included signal-to-noise ratio (SNR), contrast ratio (CR) and contrast-to-noise ratio (CNR) of common bile duct. Subjective evaluation: the scores (5-point scale) of bile ductal visibility, motion artifact, background suppression, image clarity and overall image quality of the cholangiopancreatography were assessed by two independent radiologists with more than 10-year experience in abdominal MRI diagnosis who were blind to the study, and the average score of 5 indexes was calculated. Meantime, the data acquisition time was recorded.

Results

Objective evaluation showed that the median SNR in the Ucs group was 13(9,18), significantly higher than 8(5,11) in the conventional group (Z=-3.73, P<0.05). The CNR in the Ucs group was 18(14, 25), significantly higher than 12(7, 15) in the conventional group (Z=-3.61, P<0.05). Subjective evaluation indicated that for patients with normal breathing, the scores of 5 indexes in the Ucs group were significantly higher than those in other two groups (P<0.05). For patients with respiratory disorders, bile ductal visibility, motion artifact, background suppression and overall image quality in the GRASE group were superior to those in the conventional group (P<0.05). High degree of agreement was observed between two radiologists (κ>0.8, P<0.05). For patients with normal breathing, the data acquisition time in the Ucs group was 19% shorter than that in the conventional group. For patients with respiratory disorders, the data acquisition time in the GRASE group was shortened by nearly 92% and 90% compared with those in the conventional and Ucs groups, respectively.

Conclusions

Compared with conventional scans, the image quality and data acquisition time in the Ucs group are significantly better for patients with normal breathing. For patients with respiratory disorders, rapid GRASE is recommended. MRCP sequence mainly based on Ucs assisted by fast GRASE is superior to conventional scans.

Key words: Magnetic resonanced cholangio-pancreatography, Optical shuttle imaging, Compressed sensing, Gradient spin echo, Parallel acquisition, Breathing trigger, Breath holding
表1 肝胆疾病患者MRCP扫描参数
组别 TR（ms） TE（ms） 扫描视野（mm） 扫描层厚(mm) 分辨率 体素大小（mm）
常规方案组 2 400 601.96 352×352 1.80 352×75 1.33×1.00×1.80
Ucs方案组 2 400 601.96 352×352 1.80 352×75 1.33×1.00×1.80
GRASE方案组 1 100 255 352×352 2.40 304×75 1.54×1.16×2.40
组别 翻转角（°） 回波链长度 合并加速 带宽 激励次数 压脂方法 压脂强度 采集时间（s）
常规方案组 130 140 3 300 2 SPAIR 强 204
Ucs方案组 130 140 4 300 2 SPAIR 强 166
GRASE方案组 160 33 3 1 000 1 Fat Sat 无 17
表2 MRCP图像质量参数评分标准
参数 分数 评分标准
导管可见性 1～5 1分为不可见，2分为模糊可见，3分为部分可见，4分为大部分可见，5分为完整可见
运动伪影 1～5 1分为严重伪影，2分为明显伪影，3分为中度伪影，4分为轻度伪影，5分为无任何伪影
背景抑制 1～5 1分为非常差，2分为较差，3分为一般，4分为良好，5分为优秀
图像清晰度 1～5 1分为非常模糊，2分为模糊，3分为轻度模糊，4分为清晰，边缘欠锐利，5分为清晰，边缘锐利
图像整体质量 1～5 1分为非常差，2分为较差，3分为一般，4分为良好，5分为优秀
表3 Ucs方案组、GRASE组和常规方案组图像质量的定量分析[M（Q1,Q3）]
参数 常规方案组 Ucs方案组 GRASE方案组 两两比较
统计值a P值a 统计值b P值b
SI 2 398（1 874，3 427） 2 562（1 779，3 396） 1 561（1 373，1 854） Z=-0.02 0.988 Z=-4.21 <0.001
SD 275（202，499） 195（130，270） 152（116，252） Z=-2.91 0.040 Z=-3.47 <0.001
SNR 8（5，11） 13（9，18） 7（5，12） Z=-3.73 <0.001 Z=-0.03 0.976
CR 0.97（0.96，0.97） 0.97（0.96，0.98） 0.92（0.87，0.94） Z=-0.58 0.563 Z=-5.31 <0.001
CNR 12（7，15） 18（14，25） 10（7，16） Z=-3.61 <0.001 Z=-0.02 0.988
表4 Ucs方案组、GRASE组和常规方案组呼吸均匀稳定患者图像质量的定性分析[M（Q1,Q3）]
组别 例数 导管可视化 运动伪影 背景抑制 图像清晰度 图像整体质量
常规方案组 25 4（4，4） 4（4，5） 4（4，4） 4（4，4） 4（4，4）
UCS方案组 25 5（5，5） 5（5，5） 5（4，5） 5（5，5） 5（5，5）
GRASE方案组 25 3（2，3） 3（3，4） 3（3，3） 3（2，3） 3（3，3）
H值   48.81 42.00 48.82 50.57 54.72
P值   <0.001 <0.001 <0.001 <0.001 <0.001
表5 Ucs方案组、GRASE组和常规方案组呼吸紊乱患者图像质量的定性分析[M（Q1,Q3）]
组别 例数 导管可视化 运动伪影 背景抑制 图像清晰度 图像整体质量
常规方案组 5 3（3，4） 4（3，4） 4（3，4） 4（3，4） 3（3，4）
UCS方案组 5 4（4，4） 4（3，4） 4（3，4） 4（3，4） 4（4，4）
GRASE方案组 5 5（4，5） 5（4，5） 5（4，5） 5（4，5） 5（4，5）
H值   8.46 7.02 6.93 3.88 9.88
P值   0.015 0.030 0.031 0.144 0.007
图1 一例呼吸均匀稳定患者MRCP图像注：a、b、c分别为常规方案、Ucs方案、GRASE方案扫描，Ucs方案的导管可见性、运动伪影、背景抑制、图像清晰度、锐利度整体图像质量均优于其他两组；Ucs为光梭成像，GRASE为梯度自旋回波
图2 一例呼吸紊乱稳定患者MRCP图像注：a、b、c分别为常规方案、Ucs方案、GRASE方案扫描，GRASE方案的导管可见性、运动伪影、背景抑制、图像清晰度、锐利度整体图像质量均优于其他两组；Ucs为光梭成像，GRASE为梯度自旋回波
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