摘要目的：探讨3D-SPACE（Sampling perfection with application-optimized contrasts by using different flip angle evolutions）双反转恢复（Double inversion recovery，DIR）序列在多发性硬化（Multiple sclerosis，MS）空间多发性的MR诊断中的应用价值。方法：对18例行3D-SPACE DIR序列和液体衰减反转恢复（FLAIR）序列扫描的MS患者的影像资料进行回顾性分析，查看它们显示病灶的空间分布情况。结果：18例MS患者，在小脑幕下，3D-SPACE DIR序列显示了10例患者存在分布于脑干或小脑的幕下病灶，而FLAIR序列未明显显示幕下病灶；在小脑幕上，FLAIR序列显示病灶的空间分布与3D-SPACE DIR序列相比，差别不明显，但清晰度不如3D-SPACE DIR序列。结论：3D-SPACE DIR序列在探查MS病灶的空间分布及数量方面明显优于FLAIR序列，尤其对于小脑幕下的病灶，其可以作为常规MR扫描序列的有利补充。
Abstract：Objective: To investigate the diagnostic value of 3D sampling perfection with application optimized contrasts by using different flip angle evolutions(SPACE) double inversion recovery(DIR) sequence for dissemination in space in multiple sclerosis(MS). Methods: 3D-SPACE DIR and fluid-attenuated inversion recovery(FLAIR) sequence data of 18 patients with MS were analyzed retrospectively, and the space distribution of the lesions was examined. Results: In 18 cases of MS, in subtentorial, 3D-SPACE DIR sequence displayed 10 patients with lesions located in the brainstem or cerebellum, while the FLAIR sequence had no obvious display subtentorial lesions; FLAIR sequence displaying distribution of lesions was not significantly different from 3D-SPACE DIR sequence in the supratentorial region, but the definition was not as good as the 3D-SPACE DIR sequence. Conclusion: 3D-SPACE DIR sequence is superior to FLAIR sequence in detecting the space distribution and quantity of MS lesions, especially for the infratentorial lesions, which can be used as a favorable supplement to conventional MR scanning.
李春星，符益纲，朱明明，周 仪. 3D-SPACE双反转恢复序列在多发性硬化空间多发性的MR诊断中的价值[J]. 中国临床医学影像杂志, 2018, 29(4): 238-241.
LI Chun-xing, FU Yi-gang, ZHU Ming-ming, ZHOU Yi. The diagnostic value of 3D-SPACE-double inversion recovery sequence for dissemination in space in multiple sclerosis. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(4): 238-241.
[1]Kollia K, Maderwald S, Putzki N, et al. First clinical study on ultra-high-field MR imaging in patients with multiple sclerosis: comparison of 1.5T and 7T[J]. AJNR, 2009, 30(4): 699-702.
[2]Poser CM, Paty DW, Scheinberg L, et al． New diagnostic criteria for multiple sclerosis: guidelines for research protocols[J]． Ann Neurol, 1983, 13(3): 227－231．
[3]McDonald WI, Compston A, Edan G, et al． Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis[J]． Ann Neurol, 2001, 50(1): 121－127．
[4]Polman CH, Reingold SC, Edan G, et al． Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”[J]． Ann Neurol, 2005, 58(6): 840－846．
[5]Polman CH, Reingold SC, Banwell B, et al． Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria[J]．Ann Neurol, 2011, 69(2): 292－302．
[6]Filippi M, Rocca MA, Ciccarelli O, et al. MRI criteria for the diagnosis of multiple sclerosis: MAGNIMS consensus guidelines[J]. Lancet Neurol, 2016, 15(3): 292-303.
[7]Vural G, Keklikoqlu HD, Temel S, et al. Comparison of double inversion recovery and conventional magnetic resonance brain imaging in patients with multiple sclerosis and relations with disease disability[J]. Neuroradiol J, 2013, 26(2): 133-142.
[8]任宪会，赵斌. MR双反转恢复序列在脑内多灶性病变中的临床应用研究[J]. 医学影像学杂志，2016，26（4）：715-719.
[9]Barkhof F, Filippi M, Miller DH, et al． Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis[J]． Brain, 1997, 120(Pt11): 2059－2069．
[10]Ruet A, Arrambide G, Brochet B, et al. Early predictors of multiple sclerosis after a typical clinically isolated syndrome[J]. Mult Scler, 2014, 20(13): 1721-1726.
[11]Ruet A, Deloire MS, Ouallet JC, et al. Predictive factors for multiple sclerosis in patients with clinically isolated spinal cord syndrome[J]. Mult Scler, 2011, 17(3): 312-318.
[12]Tintore M, Rovira A, Rio J, et al. Defining high, medium and low impact prognostic factors for developing multiple sclerosis[J]. Brain, 2015, 138(Pt7): 1863-1874.
[13]刘亚欧，于春水，李坤成. 临床孤立综合征的研究进展[J]. 医学影像学杂志，2006，16（8）：843-846.
[14]庄立. 临床孤立综合征转化为多发性硬化的预测指标及治疗[J]. 中国神经免疫学和神经病学杂志，2010，17（4）：290-292.
[15]O’Riordan JI, Thompson AJ, Kingsley DP, et al． The prognostic value of brain MRI in clinically isolated syndromes of the CNS. A 10-year follow-up[J]． Brain, 1998, 121(Pt3): 495-503.
[16]Okuda DT, Mowry EM, Beheshtian A, et al． Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome[J]． Neurology, 2009, 72(9): 800-805．
[17]Maia AC Jr, Rocha AJ, Barros BR, et al． Incidental demyelinating inflammatory lesions in asymptomatic patients: a Brazilian cohort with radiologically isolated syndrome and a critical review of current literature[J]． Arq Neuropsiquiatr, 2012, 70(1): 5-11．
