【摘要】 目的 评价Cube FLAIR T₂WI增强扫描序列对非小细胞肺癌（NSCLC）患者经EGFR-TKIs治疗后出现脑膜转移（LM）的早期识别价值。方法 搜集经病理明确诊断肺癌且经过靶向药治疗后出现LM患者23例，均进行增强T₁WI、矢状面Cube T₁WI与矢状面Cube FLAIR T₂WI增强扫描。所获得扫描图像由2名MRI诊断医师分别盲法阅片分析，评价内容包括脑膜是否强化、LM部位（包括幕上脑浅表区、幕下小脑脑干区及全脑区）、图像质量评价。结果 23例均成功进行增强T₁WI、矢状面Cube T₁WI与矢状面Cube FLAIR T₂WI增强扫描，获得的图像可用于质量评估。增强T₁WI与增强Cube T₁WI相比有2例位于浅表区的病变未检测出（χ²=27.74,P=0.02）,增强T₁WI与增强Cube FLAIR T₂WI相比有1例位于浅表区的病变未检测出，1例全脑病变未检测出（χ²=26.56,P=0.01）。增强T₁WI图像的CR低于增强Cube T₁WI图像（t=-0.44,P<0.05）,增强T₁WI图像的CNR等于增强Cube T₁WI图像（t=-2.49,P<0.05）。增强T₁WI图像的CR低于增强Cube FLAIR T₂WI图像（t=-0.15,P<0.05）。增强Cube T₁WI图像的CR低于增强Cube FLAIR T₂WI图像（t=-0.26,P<0.05）。增强T₁WI图像质量1例评2分，20例评3分，2例评4分；Cube T₁WI图像质量4例评3分，19例评4分（t值=1.38,P=0.03）;增强Cube FLAIR T₂WI序列图像质量4例评3分，19例评4分（t值=1.26,P=0.02）。结论 增强Cube FLAIR T₂WI图像作为容积扫描，分辨力高，对NSCLC EGFR+患者经EGFR-TKIs治疗后新发LM具有价高的敏感度，为肺癌患者靶向治疗的随访观察及个体化治疗方案提供依据。更多还原

【Abstract】 Objective To evaluate Cube FLAIR enhanced T₂WI scanning sequences for early and accurate identification of patients with non-small cell lung cancer（NSCLC） after EGFR-TKIs. Methods 23 patients with lung cancer diagnosed pathologically and with LM after targeted drug therapy were examined by enhanced T₁WI,sagittal Cube T₁WI and sagittal Cube FLAIR T₂WI.The scanned images obtained were analyzed by two MRI diagnostic physicians who analyze the images in a blind way, respectively. The evaluation contents included enhancement or not, lesion site（including supratentorial superficial brain area, subtentorial cerebellar brainstem area and whole brain area）, and image quality evaluation（qualitative evaluation and quantitative evaluation）. Results Enhanced T₁WI,sagittal Cube T₁WI and sagittal Cube FLAIR T₂WI were successfully performed in all 23 cases. The images obtained could be used for quality evaluation. Compared with enhanced Cube T₁WI,2 cases of superficial lesions were not detected（χ²=27.74,P =0.02）,compared with enhanced Cube FLAIR T₂WI,1 case of superficial lesion was not detected, and 1 case of whole brain lesion was not detected（χ²=26.56,P =0.01）.CR of the enhanced T₁WI image was lower than that of the enhanced Cube T₁WI image（t=-0.44,P< 0.05）,and CNR of the enhanced T₁WI image was equal to that of the enhanced Cube T₁WI image（t=-2.49,P< 0.05）.CR in enhanced T₁WI images was lower than that in enhanced Cube FLAIR T₂WI images（t=-0.15,P< 0.05）.CR in enhanced Cube T1WI images was lower than that in enhanced Cube FLAIR T₂WI images（t=-0.26,P< 0.05）.The image quality of enhanced T₁WI was 2 points in 1 case, 3 points in 20 cases and 4 points in 2 cases. Cube T1WI image quality was rated 3 points in 4 cases and 4 points in 19 cases（T-value =1.38,P=0.03）.Enhanced Cube FLAIR T2WI sequence image quality was 3 points in 4 cases and 4 points in 19 cases（T-value =1.26,P=0.02）. Conclusion Enhanced Cube FLAIR T₂WI images, as volume scanning, have high resolution, and are highly sensitive to new LMS in NSCLC patients treated with EGFR+ after EGFR-TKIs, providing evidence for follow-up observation and individualized treatment of lung cancer patients with targeted therapy.更多还原