Application of compressed sensing- mDIXON, spectrally attenuated inversion recovery and short-time of inversion recovery techniques in lumbar MR scanning
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摘要:
目的 研究压缩感知（CS）联合mDIXON技术、精准频率反转恢复（SPAIR）技术与短时反转恢复（STIR）技术在腰椎MR抑制脂肪效果的应用价值。 方法 选取2023年9月7日~2024年1月9日在阜阳市人民医院因腰椎疾病行MR检查的60例患者，分别进行CS-mDIXON、SPAIR与STIR技术的矢状位T2WI扫描。由2名医师采用5分制对3组图像质量进行主观评价；定量对比测量时在L2、L5椎体及L1/2、L5/S1椎间盘4组图像层面正中及相关空气区域放置感兴趣区，分别测量信号强度及噪声强度标准差，计算信噪比（SNR）及对比噪声比（CNR）。 结果 主观评分一致性良好（Kappa系数值>0.75）。CS-mDIXON技术在多种评价方面的分值均优于SPAIR技术与STIR技术（P < 0.05）。在L2、L5椎体层面中，3组技术信号值、噪声值依次增大，差异有统计学意义（P < 0.001），CS-mDIXON的SNR值及CNR值大于SPAIR和STIR技术，差异有统计学意义（P < 0.001）；在L1/2、L5/S1椎间盘层面中，CS-mDIXON技术的信号强度分别小于后两组，差异有统计学意义（P < 0.001）。3组噪声值依次增大，SNR值、CNR值依次减小，差异有统计学意义（P < 0.001）。 结论 腰椎MR扫描中，CS-mDIXON技术抑制脂肪的效果更好，同时又可减少扫描时间，可以成为腰椎MR抑脂序列扫描中最好的选择。 Abstract:Objective To study the application value of compressed sensing (CS) combined with mDIXON technique, spectrally attenuated inversion recovery (SPAIR) technique and short- time of inversion recovery (STIR) technique in lumbar MR by suppressing fat. Methods A total of 60 patients with lumbar diseases who underwent MR examination in Fuyang People's Hospital from September 7, 2023 to January 9, 2024 were selected for sagittal T2WI scans with techniques of CS-mDIXON, SPAIR and STIR. The image quality of the three groups were subjectively evaluated by two doctors using 5-point system. A region of interest was placed in the median position and relevant air area of the L2 and L5 vertebral bodies and L1/2 and L5/S1 intervertebral discs. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Results The subjective scores were consistent (Kappa>0.75). CS-mDIXON technique has better scores than SPAIR technique and STIR technique (P < 0.05); At the level of L2 and L5, the signal value and noise value of the three groups increased in turn, and the differences were statistically significant (P < 0.001). The SNR and CNR values of CS-mDIXON technique were higher than those of SPAIR and STIR technique, and the differences were statistically significant (P < 0.001); At the level of L1/2 and L5/S1, the signal intensity values of CS- mDIXON technique were lower than those of the latter two groups, and the differences were statistically significant (P < 0.001). The noise values of the three groups increased in turn, while the SNR and CNR values of the three groups decreased in turn, and the differences were statistically significant (P < 0.001). Conclusion In lumbar MR Scanning, CSmDIXON technique has a better effect on fat suppression and reduces the scanning time, and it can be the best choice for the scan of lumbar MR by fat suppressing sequence. -
Key words:
- lumbar /
- fat suppression /
- compressed sensing /
- image quality /
- magnetic resonance imaging
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图 1 ROI测量示意图，红圈示为椎体及椎间盘的ROI区域
Figure 1. Schematic diagram of ROI measurement. Red circles indicated ROI regions of the vertebral body and intervertebral disc.
图 2 患者脂肪抑制图像
Figure 2. Fat suppression images of the patient. Patients A-C were male, 43 years old; Patients D-F were female, 80 years old. A: CS-mDIXON technique scanning image, the contrast between spinal cord and cerebrospinal fluid was clear, the spinal cord was uniform, the fat suppression was significant, and the anatomical relationship was clear, all scored 5 points. The contrast between lumbar spinal cord and cerebrospinal fluid was clear, the spinal cord was uniform, and the anatomical relationship was clear; B: The score was 5 points, the fat suppression effect was 3 points, and the fat suppression in some areas of the waist was poor; C: STIR technique, with clear contrast between lumbar spinal cord and cerebrospinal fluid, uniform spinal cord, and clear anatomical relationship, all scored 5 points, and fat suppression effect scored 4 points; D: CS- mDIXON scan image, with clear contrast between spinal cord and cerebrospinal fluid, uniform spinal cord, significant fat suppression, and clear anatomical relationship, all of which were 5 points; E: SPAIR scan image, the contrast between lumbar spinal cord and cerebrospinal fluid was clear, the spinal cord was even, and the anatomical relationship was clear, all scored 5 points, the fat suppression effect was 2 points, the fat suppression in some areas of the lumbar spine failed, and the water suppression in the upper edge of the lumbar spine was partial; F: STIR scanning image, the contrast between lumbar spinal cord and cerebrospinal fluid was clear, the spinal cord was relatively uniform, the anatomical relationship was still clear, all scored 4 points, and the fat suppression effect was also scored 4 points.
表 1 3种脂肪抑制技术扫描参数
Table 1. Scanning parameters of three fat suppression techniques
Scanning parameters CS-mDIXON SPAIR STIR TR（ms） 2500 3327 3500 TE（ms） 105 80 80 Matrix 200×241 200×241 200×241 FOV 180×320 180×320 180×320 NEX 1 1 1 Echo train length 19 19 19 Slice thickness（mm） 4 4 4 Interlamellar spacing（mm） 0.4 0.4 0.4 Scanning time（s） 105 140 147 TR: Time of repetition; TE: Time of echo; FOV: Field of view; NEX: Number of excitations; CS: Compressed sensing; SPAIR: Spectrally attenuated inversion recovery; STIR: Short time of inversion recovery. 
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表 2 两位观察者主观评分结果一致性检验
Table 2. Consistency test of subjective scoring results of two observers [M(P25, P75)]
Index CS-mDIXON SPAIR STIR Comparison of spinal cord Doctor 1 4.93（5, 5） 4.87（5, 5） 4.81（5, 5） Doctor 2 4.92（5, 5） 4.83（4, 5） 4.80（5, 5） Kappa 0.88 0.87 0.937 Effect of fat suppression Doctor 1 4.87（5, 5） 4.58（4, 5） 4.83（5, 5） Doctor 2 4.87（5, 5） 4.61（4.75, 5） 4.78（5, 5） Kappa 1 0.959 0.802 Uniformity of spinal cord Doctor 1 4.92（5, 5） 4.88（5, 5） 4.87（5, 5） Doctor 2 4.90（5, 5） 4.85（4, 5） 4.83（5, 5） Kappa 0.9 0.849 0.864 Normal anatomy Doctor 1 4.93（5, 5） 4.92（5, 5） 4.90（5, 5） Doctor 2 4.90（5, 5） 4.90（5, 5） 4.82（5, 5） Kappa 0.762 0.9 0.776
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表 3 图像质量主观评价
Table 3. Subjective evaluation of image quality (n=60)
Index CS-mDIXON SPAIR STIR Comparison of spinal cord and cerebrospinal fluid Mean score [M(P25, P75)] 4.93（5, 5） 4.87（5, 5） 4.81（5, 5） 1 point 0 0 0 2 points 0 0 0 3 points 0 0 2 4 points 4 8 7 5 points 56 52 51 Uniformity of spinal cord Mean score [M(P25, P75)] 4.92（5, 5） 4.88（5, 5） 4.87（5, 5） 1 point 0 0 0 2 points 0 0 0 3 points 0 0 0 4 points 5 7 8 5 points 55 53 52 Effect of fat suppression Mean score [M(P25, P75)] 4.87（5, 5） 4.58（4, 5） 4.83（5, 5） 1 point 0 0 0 2 points 0 2 0 3 points 2 5 2 4 points 4 9 6 5 points 54 44 52 Normal anatomy Mean score [M(P25, P75)] 4.93（5, 5） 4.92（5, 5） 4.90（5, 5） 1 point 0 0 0 2 points 0 0 0 3 points 0 0 0 4 points 4 5 7 5 points 56 55 53
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表 4 图像质量客观评价
Table 4. Objective evaluation of image quality (Mean±SD)
Level of measurement CS-mDIXON SPAIR STIR L2 vertebral body level SI 164.19±52.95 400.41±126.00 513.67±98.56 N 6.18±3.70 37.45±19.55 67.28±44.58 SNR 38.95±39.05 14.85±11.71 13.51±14.07 CNR 36.85±36.49 13.98±11.28 12.47±13.05 L5 vertebral body level SI 148.43±40.27 350.21±90.71 500.02±138.05 N 6.20±3.10 33.15±15.62 62.48±29.22 SNR 31.37±19.82 13.27±7.29 10.55±6.64 CNR 28.90±18.65 12.21±6.85 9.70±6.22 L1/2 intervertebral disc level SI 436.87±177.16 923.62±270.14 999.36±439.99 N 4.52±2.18 23.13±9.48 42.06±18.96 SNR 73.70±34.17 30.44±13.26 19.91±13.90 CNR 72.22±33.65 29.47±12.89 19.06±13.44 L5/S1 intervertebral disc level SI 312.96±131.38 660.64±257.98 766.91±471.83 N 4.04±2.20 20.89±9.45 40.18±17.62 SNR 70.70±66.88 26.06±15.75 14.99±13.86 CNR 69.00±66.63 24.92±15.31 14.14±13.64 SI: Signal intensity; N: Noise; SNR: Signal-to-noise ratio; CNR: Contrast-to-noise ratio.
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