高分辨率2D与3D腰椎MRI对比：深度学习重建算法与原型适形线圈的优化研究
该前瞻性研究纳入31例腰椎曲度受试者，在3T下使用原型适形高密度线圈和深度学习重建（DLR），比较2D与3D腰椎MRI协议。结果显示3D序列总体扫描时间减少14%（T2序列减少38%），图像质量与2D相似，3D T2脑脊液流动伪影更少，椎管面积、椎间孔狭窄和骨折检测的评分者间一致性良好。
要点
- DLR辅助3D腰椎MRI图像质量与2D相当，且扫描时间更短（总体减少14%，T2减少38%）。
- 3D T2序列脑脊液流动伪影少于2D T2序列，有助于观察椎管及椎间孔。
- 椎管面积（ICC 0.941-0.952）、椎间孔狭窄（AC2 0.706-0.832）和骨折检测（AC1 0.815-0.869）的一致性良好。
关键影像表现/征象
- 3D T2序列的脑脊液流动伪影少于2D T2序列。
- 所有3D序列的图像质量与2D序列相似。
诊断标准与关键数值
- 椎管面积评估的组内相关系数：2D为0.952（95%CI 0.907-0.976），3D为0.941（95%CI 0.866-0.973）。
- T2序列椎间孔狭窄评估的Gwet AC2：2D为0.713-0.795，3D为0.706-0.832。
- T1序列骨折检测的Gwet AC1：2D为0.869，3D为0.815。
临床应用与阅片要点
- 在日常腰椎MRI中，可考虑采用DLR辅助的3D序列以缩短扫描时间，尤其T2序列时间减少38%。
- 3D T2序列因脑脊液流动伪影较少，可能更利于观察椎管和椎间孔区域。
- 尽管图像质量与2D相似，但骨折检测的AC1在3D略低（0.815 vs 0.869），报告时需结合其他序列综合判断。
局限性
- 研究为单中心前瞻性设计，样本量较小（n=31）。
- 使用原型线圈和原型DLR技术，尚未广泛商用。
- 仅纳入有腰椎曲度的受试者，可能影响普遍性。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
BACKGROUND AND PURPOSE: Lumbar spine MRI is predominantly performed using 2D FSE sequences. 3D FSE sequences offer potential advantages over 2D, especially with recent advances in deep-learning reconstruction (DLR) and the use of conformal high-density coil arrays to improve the SNR. This study aimed to compare image quality and diagnostically relevant differences between 2D and 3D lumbar spine protocols, both using a prototype conformal coil and DLR.
MATERIALS AND METHODS: Subjects with lumbar curvature referred for routine lumbar spine MRI were prospectively recruited (n=31). A prototype, conformal spine coil array with 70 total posterior receiver elements was used at 3T. DLR was applied to both the 2D- and 3D-protocols to improve sharpness and reduce noise. For 3D, a prototype DLR ("Sonic DL") technique was applied to provide higher acceleration factors. Three attending musculoskeletal radiologists assessed 2D and 3D T1-weighted (T1), T2-weighted (T2), and STIR sequences for image quality and diagnostic performance. The Gwet agreement coefficient (AC1, AC2) or intraclass correlation (ICC) was used to assess interrater agreement, while the Wilcoxon signed rank test or a sign test with Bonferroni correction assessed differences between 2D and 3D sequences.
RESULTS: There was an overall 14% scan time reduction of 3D compared with 2D sequences, and a 38% time reduction for T2 sequences. All 3D sequences exhibited similar image quality to 2D. 3D T2 sequences had less CSF flow artifact than 2D T2 sequences. Interrater agreement was mostly comparable between all 2D and 3D assessments, including excellent agreement for the spinal canal area (ICC = 0.952 [95% CI: 0.907-0.976] for 2D, 0.941 [0.866-0.973] for 3D), good agreement for foraminal stenosis assessments on T2 sequences (AC2 = 0.713 to 0.795 for 2D, 0.706-0.832 for 3D), and good agreement for fracture detection on T1 sequences (AC1 = 0.869 for 2D, 0.815 for 3D).
CONCLUSIONS: DLR-enabled 3D lumbar spine MRI offers comparable image quality to 2D with reduced overall scan time.
引用
- Sahr M, Lowe A, Sneag DB, et al. High-Resolution 2D versus 3D Lumbar Spine MRI Optimized with a Deep Learning Reconstruction Algorithm and Prototype Conformal Coil. AJNR Am J Neuroradiol. 2026. PMID: 42082312. doi:10.3174/ajnr.A9141
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。