An unenhanced 3D-FLAIR sequence using long repetition time and constant flip angle to image endolymphatic hydrops.

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING European Radiology Pub Date : 2025-01-01 Epub Date: 2024-07-10 DOI:10.1007/s00330-024-10906-1

Menglong Zhao, Huaili Jiang, Shujie Zhang, Kai Liu, Lei Zhou, Di Wu, Xixi Wen, Junpu Hu, Xuan Wang, Zhuang Liu, Yan Sha, Mengsu Zeng

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Abstract

Objectives: To evaluate a three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequence using a long repetition time (TR) and constant flip angle (CFA) in differentiating between perilymph and endolymph in a phantom study, and unenhanced endolymphatic hydrops (EH) imaging in a patient study.

Methods: Three solutions in similar ion and protein concentrations with endolymph, perilymph, and cerebrospinal fluid were prepared for variable flip angle (VFA) 3D-FLAIR (TR 10,000 ms) and CFA (120°) 3D-FLAIR using different TR (10,000, 16,000, and 20,000 ms). Fifty-two patients with probable or definite Meniere's disease received unenhanced CFA (120°) 3D-FLAIR using a long TR (20,000 ms) and 4-h-delay enhanced CFA (120°) 3D-FLAIR (TR 16,000 ms). Image quality, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of them were compared. Agreement in the evaluation of the EH degree between them was analyzed.

Results: In the phantom study, CNRs between perilymphatic and endolymphatic samples of VFA 3D-FLAIR (TR 10,000 ms) and CFA 3D-FLAIR (TR 10,000, 16,000, and 20,000 ms) were 6.66 ± 1.30, 17.90 ± 2.76, 23.87 ± 3.09, and 28.22 ± 3.15 (p < 0.001). In patient study, average score (3.65 ± 0.48 vs. 4.19 ± 0.40), SNR (34.56 ± 9.80 vs. 51.40 ± 11.27), and CNR (30.66 ± 10.55 vs. 45.08 ± 12.27) of unenhanced 3D-FLAIR were lower than enhanced 3D-FLAIR (p < 0.001). Evaluations of the two sequences showed excellent agreement in the cochlear and vestibule (Kappa value: 0.898 and 0.909).

Conclusions: The CFA 3D-FLAIR sequence using a long TR could be used in unenhanced EH imaging with high accuracy.

Clinical relevance statement: Unenhanced imaging of endolymphatic hydrops is valuable in the diagnosis and follow-up of patients, especially those who cannot receive contrast-enhanced MRI.

Key points: Ion and protein concentration differences can be utilized in differentiating endolymph and perilymph on MRI. Endolymphatic and perilymphatic samples could be differentiated in vitro on this 3D-FLAIR sequence. This unenhanced 3D-FLAIR sequence is in excellent agreement with the enhanced constant flip angle 3D-FLAIR sequence.

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使用长重复时间和恒定翻转角的未增强三维-FLAIR 序列对内淋巴水肿进行成像。

目的在一项模型研究中评估使用长重复时间（TR）和恒定翻转角（CFA）的三维流体增强反转恢复（3D-FLAIR）序列在区分淋巴和内淋巴方面的效果，并在一项患者研究中评估未增强的内淋巴水肿（EH）成像效果：制备了三种离子和蛋白质浓度与内淋巴、淋巴结和脑脊液相似的溶液，使用不同的 TR（10,000、16,000 和 20,000 毫秒）进行可变翻转角 (VFA) 3D-FLAIR (TR 10,000 毫秒) 和 CFA (120°) 3D-FLAIR 成像。52 名可能或确定患有梅尼埃病的患者接受了使用长 TR（20000 毫秒）的未增强 CFA（120°）3D-FLAIR 和 4 h 延迟增强 CFA（120°）3D-FLAIR（TR 16000 毫秒）。对两者的图像质量、信噪比（SNR）和对比度-噪声比（CNR）进行了比较。结果：在模型研究中，VFA 3D-FLAIR 序列（TR 10,000 ms）和 CFA 3D-FLAIR 序列（TR 10,000, 16,000, 20,000 ms）的虹膜周围样本和内淋巴样本之间的 CNR 分别为 6.66 ± 1.30、17.90 ± 2.76、23.87 ± 3.09 和 28.22 ± 3.15（p 结论）：采用长TR的CFA三维-FLAIR序列可用于EH的非增强成像，准确性高：内淋巴水肿的非增强成像在诊断和随访患者，尤其是无法接受对比增强磁共振成像的患者方面很有价值：要点：离子和蛋白质浓度差异可用于在核磁共振成像上区分内淋巴和淋巴周围。这种三维-FLAIR序列可在体外区分内淋巴和淋巴周围样本。这种未增强三维-FLAIR序列与增强恒定翻转角三维-FLAIR序列非常吻合。

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来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.