通用脉冲增强7T MPRAGE用于颅内肿瘤成像的初步可行性
结果显示通用脉冲图像在整体质量、病灶显著性、小脑显示方面评分更高，对比度比值均显著改善。
要点
- 通用脉冲模式可改善增强7T MPRAGE的场不均匀性，幕下增强病灶显示更清晰。
- 通用脉冲与常规模式伪影评分无显著差异，临床切换不增加伪影负担。
- 对后颅窝肿瘤患者，7T增强MPRAGE使用通用脉冲更适合用于病灶显著性评估。
核心结论
- 通用脉冲可用于生成高质量且均匀的增强7T MPRAGE图像，用于肿瘤患者颅内强化病灶的显示。
研究设计与样本
- 使用增强7T MPRAGE序列，分别以常规圆极化模式和通用脉冲模式采集图像。
- 由两名放射科医生和一名放射科学员基于5分Likert量表评估整体图像质量、伪影、病灶显著性和小脑显示。
- 通过感兴趣区分析测量强化病灶与白质、灰质的对比度比值，以及脑桥臂白质与幕上白质、灰质的对比度比值。
关键影像表现/征象
- 通用脉冲模式增强7T MPRAGE在整个脑内提供均匀的图像对比，幕下区域强化病灶边界清晰。
诊断标准与关键数值
- 整体图像质量评分：通用脉冲模式高于常规圆极化模式（p<0.001）。
- 病灶显著性评分：通用脉冲模式高于常规圆极化模式（p<0.001）。
- 小脑显示评分：通用脉冲模式高于常规圆极化模式（p<0.001）。
- 伪影评分：两种模式无显著差异（p=0.394）。
- 强化病灶与白质对比度比值：通用脉冲模式显著高于常规圆极化模式（p<0.001）。
临床应用与阅片要点
- 对后颅窝肿瘤患者行7T增强MPRAGE时，优先选择通用脉冲模式以获得更均匀的强化显示。
- 通用脉冲模式不增加伪影，可常规用于颅内肿瘤7T增强成像流程。
局限性
- 原文仅报告为初步研究，未提及样本量计算或与更低场强设备的直接比较。
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
PURPOSE: Contrast-enhanced 7T MPRAGE is promising for imaging intracranial tumor but suffers from strong intensity inhomogeneities. This study investigated the clinical feasibility of contrast-enhanced 7T MPRAGE with universal pulses (UP) for intracranial tumor imaging.
METHODS: Contrast-enhanced 7T MPRAGE images with conventional circularly polarized (CP) and UP modes were prospectively obtained from patients with known or suspected infratentorial tumors. Two radiologists and a radiology trainee evaluated qualitative image quality scores of the CP and UP images in terms of overall image quality, artifacts, lesion conspicuity, and visualization of cerebellum based on 5-point Likert scales. Contrast ratios (CRs) of enhancing lesion to white matter (CRlesion/WM) and gray matter (CRlesion/GM), and white matter in the brachium pontis to white matter (CRBP/WM) and gray matter (CRBP/GM) in the supratentorial region were measured using region of interest analysis.
RESULTS: Fifty-two patients with various infratentorial tumors were included in this study. Contrast-enhanced 7T MPRAGE with UP provided homogeneous image contrast throughout the brain, and clear delineation of enhancing lesions in infratentorial regions. Compared to conventional CP images, UP images achieved higher image quality scores in terms of overall image quality, lesion conspicuity, and visualization of cerebellum scores (p < 0.001), with no significant difference in artifacts scores (p = 0.394). Meanwhile, UP images achieved significantly improved CRlesion/WM, CRlesion/GM, CRBP/WM, and CRBP/GM in comparison to CP images (p < 0.001).
CONCLUSION: UP can be used to generate high-quality and homogeneous contrast-enhanced 7T MPRAGE images for visualization of intracranial enhancing lesions in oncology patients.
引用
- Duan, Zhang, Bian, et al. Clinical feasibility of contrast-enhanced 7 T MPRAGE with universal pulses for intracranial tumor imaging: a preliminary study. Neuroradiology. 2026. PMID: 42223523. doi:10.1007/s00234-026-04050-4
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。