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目的采用定性及定量评价方法,探讨三维水选择性激励序列(3D T1W-WATS)在儿童血友病性骨关节病软骨显示中的价值。方法 2015年2月在首都医科大学附属北京儿童医院进行随诊复查并行磁共振(MR)检查的16例血友病患儿,对其16个关节包括8个膝关节和8个踝关节(13个关节有含铁血黄素沉积)在3T MR上行矢状位3D T1W-WATS序列和2D T2*W序列扫描,定量比较两个序列的软骨信噪比及软骨与周围组织的相对对比度,定性比较两个序列中部分或完全受含铁血黄素掩盖的软骨亚分区数目。信噪比及相对对比度计算公式为SNRcartilage=SI软骨/SD噪声,r CN=(SI软骨-SI周围组织)/(SI软骨+SI周围组织),13个含铁血黄素沉积关节的关节软骨被分成142个软骨亚分区。结果 3D T1W-WATS序列的软骨信噪比为(53.93±18.80),2D T2*序列的软骨信噪比为(52.96±24.32),两个序列间差异没有统计学意义(P>0.05)。3D T1W-WATS序列的软骨与骨髓、软骨与积液及软骨与脂肪的相对对比度优于2D T2*W序列;在142个软骨亚分区中,2D T2*W序列中有42个亚分区软骨部分或完全地被含铁血黄素掩盖,明显多于3D T1W-WATS序列中的16个软骨亚分区,两个序列受含铁血黄素掩盖软骨亚分区数差异有统计学意义(P<0.05)。结论 3D T1W-WATS序列具有高分辨率,高信噪比及优异的软骨对比度,而且软骨不易受含铁血黄素影响,对血友病性骨关节病软骨显示优于2D T2*W序列。
Objective To investigate the value of 3D T1W-WATS in the cartilage display of hemophilic osteoarthritis in children by qualitative and quantitative evaluation methods. Methods A total of 16 children with hemophilia who underwent repeat magnetic resonance (MR) examination at the Beijing Children’s Hospital, Capital Medical University in February 2015 were enrolled in this study. Their 16 joints, including 8 knees and 8 ankles (13 The joints were hemosiderin-containing). The 3D T1W-WATS sequence and the 2D T2 * W sequence scan of the sagittal plane of the 3T MR were used to quantitatively compare the signal-to-noise ratio of cartilage and the relative contrast between the cartilage and surrounding tissues. The number of subdivisions of cartilage partially or completely covered by hemosiderin in both sequences. The signal to noise ratio and relative contrast were calculated as SNR cartilage = SI cartilage / SD noise, r CN = (SI cartilage-SI surrounding tissue) / (SI cartilage + SI surrounding tissue), and 13 articular cartilage of hemosiderin- Divided into 142 cartilage sub-sub-area. Results The cartilage signal-to-noise ratio of 3D T1W-WATS was (53.93 ± 18.80) and that of 2D T2 * was (52.96 ± 24.32). There was no significant difference between the two sequences (P> 0.05). The relative contrast between cartilage and bone marrow, cartilage and effusion and cartilage and fat in the 3D T1W-WATS sequence was superior to that of the 2D T2 * W sequence. Among the 142 cartilaginous subdivisions, there were 42 subregion cartilage parts in the 2D T2 * W sequence Or completely masked by hemosiderin, was significantly more than the 16 cartilaginous sub-regions in the 3D T1W-WATS sequence. There were significant differences in sub-regions of the two sequences covered by hemosiderin (P <0.05). Conclusion The 3D T1W-WATS sequence has high resolution, high signal-to-noise ratio and excellent cartilage contrast. Cartilage is not easily affected by hemosiderin and exhibits superiority to 2D T2 * W sequence in hemophilic osteoarthritis cartilage.