简体中文

论著-头颈部

3.0T MR全泪道成像 的可行性研究*

作者:郭学军1 高 敏2 戚玉龙1 王成林1 成官迅1 石 桥1

所属单位:1.北京大学深圳医院医学影像科 2.北京大学深圳医院肾内科 (广东 深圳 518036)

PDF

摘要

目的 探索磁共振全泪道成像的 可行性方法,并优选最佳扫描方案。方 法 选择30例无如何眼疾的健康志愿者(60 侧泪道)进行泪道MRI检查。检查前向双侧 结膜囊内滴入玻璃酸钠滴眼液,采用颈动 脉线圈,30例均行3D-CISS(结构干扰稳态 进动成像)、3D-SPC(可变翻转角快速自 旋回波)和2D-TSE(快速自旋回波)序列扫 描,其中8例加扫3D-DE(双回波稳态进动 成像)和3D-ME(多回波合并成像)序列。分 析各序列原始图像,并进行最大强度投影 (MIP)处理。观察不同序列图像的泪道各 结构的显示情况。结果 3D-CISS、3D-SPC 和2D-TSE序列均可全程显示泪道各结构, 但以2D-TSE显示最佳,其图像对比度和信 噪比高,对泪道各部分的显示率均可达到 接近100%,3D-SPC序列显示率也达到80% 以上。结论 采用高分辨率颈动脉线圈和 玻璃酸钠滴眼充盈泪道的方法,可完美实 现全泪道无创成像。薄层2D-TSE序列可作 为泪道检查的优选序列,3D-SPC序列可作 为补充序列。

Objective To explore the feasibility of MR dacryocystography of whole lacrimal passages, and to optimize the scanning scheme. Methods Thirty healthy volunteers without any eye diseases (60 lacrimal passages) were selected and underwent MR dacryocystography. The bilateral conjunctival sacs were instilled by sodium hyaluronate eye drops before the examination. By carotid coil, 30 cases were scanned with 3D-CISS, 3D-SPC and 2D-TSE sequence, and 8 of 30cases with extra 3D-DE scan and 3D-ME sequence. Every components of lacrimal passages were observed by analyzing the original images and maximum intensity projection (MIP) in different sequences. Results 3DCISS, 3D-SPC and 2D-TSE sequence can reveal the components of whole lacrimal passages, but contrast and the signal-to-noise ratio of the images in 2D-TSEsequence are better than others. The display rate of every component of the lacrimal passages can reach to about 100%, and more than 80% in 3D-SPC sequence. Conclusion The method The perfect andnon-invasive MR dacryocystography of whole lacrimal passages can be come true by combining high resolution carotid coil and sodium hyaluronate eye drops. The 2D-TSE sequence can be used to optimize the sequence of MR dacryocystography of whole lacrimal passages, and 3D-SPC sequence can be used as a supplemental sequence.

【关键词】全泪道;磁共振成像

【中图分类号】R777.2+1

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.11.001

前言

传统的泪道检查方法如泪道冲洗、X线或CT泪道造影、荧光素显 像、核素造影等均需局部麻醉后通过泪点穿刺插管注入人工对比剂后 进行泪道充盈,间接或直接判断泪道阻塞的部位。但这些方法均有一 定创伤,且操作复杂,患者感觉较痛苦,部分患者难以忍受而无法配 合,而且对于泪道阻塞的部分原因难以显示,评估价值有限;同时, 这些医源性操作还可能加重泪道粘膜的损伤影响疗效。MRI泪道成像 (MR Dacryocystography,MRD)以其无创性和良好的软组织分辨力近年 来开始受到临床医师的重视,但往往不能很好地显示泪道全程。本研 究应用3.0T MR对30例健康志愿者进行泪道成像,探讨全程显示泪道的 方法,并筛选出最佳的扫描技术和方案。