TrueFISP 2005 5
1 2 3 4 5 6 7 14 15 23 24 TrueFISP 25 32 TrueFISP 33 35 36 37 42 43 49 50 51 52
TrueFISP TrueFISP T1WI-FLASH DESS FSE-PDWI TrueFISP 10 6 4 21 40 28.5 SNR CNRc/f CNRc/f CNReff CNRc/f SNR CNRc/f CNReff : 1. SNR CNRc/f CNReff F 255.92 96.18 193.22 P 0.05 2. SNR FLASH FSE-PDWI TrueFISP-2&DESS TrueFISP-1;CNRc/f TrueFISP-2&DESS TrueFISP-1 FLASH FSE-PDWI; CNReff TrueFISP-2 DESS& TrueFISP-1 FLASH& FSE-PDWI TrueFISP-2 TrueFISP SNR CNR TrueFISP
TrueFISP TrueFISP FLASH FSE-PDWI 21 TrueFISP T1WI-FLASH 13 FSE-PDWI 8 Kappa 15 36 TrueFISP 83.3% FSE-PDWI 57.1% P<0.05 TrueFISP FLASH FLASH FSE-PDWI P>0.05 Kappa 0.77 0.68 0.60 TrueFISP MR TrueFISP
Abstract The value of TrueFISP sequence in diagnosis defects in hyaline cartilage Part 1 Purpose: To explore the feasibility of optimized TrueFISP sequence for detection of defects in the hyaline cartilage of the knee. Meterials and Methods: A single knee of each of 10 volunteers was scanned using five sequences, include T1WI-FLASH, DESS,FES-PDWI and two TrueFISP sequence after optimized. Measured the singal intensity of the hyaline cartilage of patellar facets, synovial fluid and background noise respectively. The SNR of hyaline cartilage, CNR of hyaline cartilage to synovial fluid and CNReff was calculated for each of the five sequences. CNReff is CNR divided by the square-root of the scan time. Statistically significant differences in SNR CNR and CNReff were determined. Friedman test was used to determine the synthetical score of each sequence. Results: 1. the SNR,CNRc/f and CNReff of the five sequences had statistically significant differences(f is 255.92 96.18 193.22respectively. P 0.05). 2. FOR SNR FLASH FSE-PDWI TrueFISP-2&DESS TrueFISP-1; as CNRc/f TrueFISP-2&DESS TrueFISP-1 FLASH FSE-PDWI; CNReff TrueFISP-2 DESS& TrueFISP-1 FLASH& FSE-PDWI. TrueFISP sequence has the highest value of synthetical score. Conclusion: The optimized TrueFISP sequence can image cartilage with excellent CNRc/f in shorter scan time. The optimized TrueFISP sequence can be used to detect of defects of the hyaline cartilage in the knee.
Part 2 Purpose: to prospectively compare TrueFISP sequence with FLASH and FSE-PDWI sequence for detection of defects in the hyaline cartilage of the knee, using arthroscopy as the gold standard. Meterials and Methods: 21 patients were involved in this study. hyaline cartilage was imaged with a TrueFISP sequence with previously determined optimal imaging parameters and 3D-T1WI-FLASH sequence, and 13 patients imaging with 2D FSE PDWI sequence at same time. All sequences include axial and sagittal imaging. With arthroscopy as the reference standard. Sensitivity, specificity and value of Kappa of each sequence for detecting cartilage defects were determined by articular surface(eight surfaces in each patient: medial and lateral patellar facets, trochlear facets, femoral condyles, and tibial plateaus). Statistically significant differences in sensitivity specificity and value of Kappa were determined. Results: Arthroscopy showed 36 cartilage defects in 15 patients. The TrueFISP sequence had higher sensitivity (83.3%) than FSE-PDWI sequence (57.1%, P<0.05). the sensitivity of TrueFISP sequence and FLASH sequence had not statistically significant differences, the same as FLASH and FSE-PDWI sequence. The specificity of the three sequence had not statistically significant differences. The Kappa was 0.77,0.68,0.60 respectively. Conclusion: The TrueFISP imaging has higher sensitivity for the detection of defects of the hyaline cartilage in the knee. Routine use of this technique may strengthen the role of MR imaging for the detection of defects of the hyaline cartilage in the knee. Key words Cartilage, articular; knee injuries, magnetic resonance imaging, TrueFISP
CNR, contrast-to-noise ratio CNReff effective of contrast-to-noise ratio DEFT, driven equilibrium fourier transform DESS, double-echo steady-state DWI diffusion-weighted imaging EPI, echo planar imaging FEMR fluctuating equilibrum magnetic resonance FISP, fast imaginng with steady state precession FLASH, fast low angle shot FOV, field of view FS, fat saturation FSE, fast spin echo GE gradient echo MRI magnetic resonance imaging MRPAGE, fast imaging employing steady-state acquisition MTI magnetic transfer imaging PDWI, proton density weight image RF, radiofrequency SE spin echo SPGR, spoiled gradient-recalled SNR singal- to- noise ratio SSFP, steady-state free procession STIR, short time inversion recovery TE, echo time TR, repetition time TrueFISP, true fast imaging with steady precession
T1WI T1 weight image T1 T2WI, T2 weight image T2
MR, 1 4, 75 70 % 90 % 2,3 65 60 90 %,45 65 25 30 % 4, 5,6,, MR 7, MRI, MRI 8-10,, 75 80 %,,, ; 20 60 %,,, 4 :, 10 %,,,
, 40 %, :, ; 5 30 %, ( Na + ),,, : ;, 11 4 :, ;, ;,, (12) 4, ;, ;,, Shahriaree (11) MRI 4, :, ;,
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MRI, MR MR, MRI, MRI 4, Modl (22) SE T1WI :,, TE, 4 :, ;, ;, ; Uhl 23 MRI MRI 3 Lehner (24) T1WI T2WI T1WI T2WI T1WI T2WI 2 Disler (25) SPGR-T1WI 3,,, Erickson 26 truncation artifact FSE
magic angle effect 55, T2 27, 55,, T2WI,,, MR MR SE T1WI, 70 % (28 ),, T2WI T2 T2WI SE FSE 2D FSE-PDWI T2 blurring FSE T2WI Potter (29) FSE T2WI, 87 %, 94 %, 92 % FSE T2WI FSE-PDWI SPGR(FLASH) 3D Disler
30, (3D FS SPGR) T1WI,, 3D FS SPGR Cohen 31,3D SPGR (FS) 0.3mm 10 5 TR T1WI SPGR SPGR TR SPGR T1 TR 3D TE T2* SNR TR SNR T2 * SNR FSE FSE RARE T2 SNR T2 5 MR (steady-state free precession,ssfp), SSFP,,,
3D-SSFP,, 3D-FS-SPGRE 42 % (32) (fluctuating equilibrum magnetic resonance,femr), SSFP,, FEMR, 33 DEFT ( drivenequilibrium fourier transform) 90 Z T1 T1 T2 T1/T2 TE TR Hargreaves 34, DEFT SPGR FSE,DEFT CNR SPGR FSE 4 DESS Ruehm 35 DESS FSE DESS FSE FSE FSE EPI Karantanas 36 3D EPI 3D-T1WI-GRE EPI 3D-T1WI-EPI SNR 3D-T1WI-GRE 3D-T1WI-GRE DWI T2 SNR DWI DWI 37 MTC: MTC MTC, MTC, Vahlensieck (38) MTC SE, MTC,
dgemric T1 mapping 23NA T2mapping T2mapping T2mapping 7 MRI,, MRI MRI, MR,,, MRI, MR,, MR