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目的 7TMRI应用T2*加权序列显示了多发性硬化(MS)的新病理特征。但7T的临床MRI方案却从未审查过。通过对比3T的病变检出敏感度来评估7TMRI的临床价值。方法 38例MS病人和8名健康对照者均行3T及7T多对比MRI3DT1加权(3D-T1W)、T2加权(2D-T2W)及3D液体衰减反转恢复(3D-FLAIR)成像。分析局灶病变,计数并根据解剖位置分类。本研究经机构审查委员会批准。结果精密病变分析表明,与3T检出结果相比,7TMRI扫描检出更多皮质灰质(GM)病灶,3D-T1W、2D-T2W、FLAIR序列分别检出91%、75%、238%。证实了7TMRI2D-T2W、FLAIR序列可检出更多GM病变(P<0.023和P<0.001)。7T白质(WM)病变检出并未增多,反而3T3D-FLAIR检出相当多的WM病变。结论应用临床多对比MRI方案可检出更多皮质GM病变而非WM。如果GM异常能与临床结合,这或许可以给临床提供与GM异常相关的结果测量、预期分类及未来的诊断标准。要点①标准多对比7TMRI检查多发性硬化是可行的。②7TMRI可比3T检出更多皮质灰质病变。③白质病变检出中,7TMRI并不比3T更有优势。④灰质异常与MS的诊断及预期方面有很大关联。
Purpose 7T MRI uses the T2 * weighted sequence to show new pathological features of multiple sclerosis (MS). However, 7T clinical MRI program has never been examined. The clinical value of 7 TMRI was evaluated by comparing the sensitivity of the 3T lesion detection. Methods Thirty-eight patients with MS and eight healthy controls underwent 3T and 7T contrast 3D-T1W, 2D-T2W and 3D-FLAIR imaging. Focal lesions were analyzed, counted and classified according to anatomic location. This study was approved by the Institutional Review Board. Results The results of the precise lesion analysis showed that compared with the detection results of 3T, more lesions of cortical gray matter (GM) were detected by 7T MRI scan. The sequences of 3D-T1W, 2D-T2W and FLAIR were 91%, 75% and 238%, respectively. Confirmed 7TMRI2D-T2W, FLAIR sequence detected more GM lesions (P <0.023 and P <0.001). 7T white matter (WM) lesions detected did not increase, but 3T3D-FLAIR detected a considerable number of WM lesions. Conclusions More cortical GM lesions can be detected in clinical multi-contrast MRI than WM. If GM abnormalities can be combined with clinical practice, this may provide clinically useful measures of outcome related to GM abnormalities, the expected classification, and future diagnostic criteria. The main points ① standard multi-contrast 7TMRI multiple sclerosis is feasible. ② 7TMRI detected more than 3T cortical gray matter lesions. ③ White matter lesions detected, 7TMRI is no more advantages than 3T. ④ gray matter abnormalities and MS diagnosis and expectations are closely related.