【摘要】 目的 探讨可变翻转角快速自旋回波T₁对比增强序列（CE-T₁＿SPACE）在肺癌脑转移瘤中的应用价值。方法 选择自2022年1月至2024年9月于信阳市中心医院接受3.0 T MRI扫描的肺癌并脑转移瘤患者45例，患者分别接受磁共振平扫和T₁对比增强快速小翻转角梯度回波2 d序列（CE-T₁＿fl2d）、T₁对比增强磁化准备超快速梯度回波序列（CE-T₁＿MPRAGE）和T₁对比增强可变翻转角快速自旋回波序列（CE-T₁＿SPACE）检查，由2名高年资医生对磁共振图像判读，测量转移灶长径大小，将所有病灶分为<3 mm、3～10 mm、>10 mm,记录病灶的部位；比较3种序列对不同长径、不同部位肺癌脑转移瘤检出率的差异。结果 CE-T₁＿fl2d、CE-T₁＿MPRAGE和CE-T₁＿SPACE序列对肺癌脑转移瘤病灶的检出率依次升高（分别为70.0%、89.7%、99.0%）,差异有统计学意义（P<0.05）。CE-T₁＿fl2d、CE-T₁＿MPRAGE和CE-T₁＿SPACE序列对长径<3 mm肺癌脑转移瘤检出率（分别为45.2%、78.6%、97.6%）依次升高，差异有统计学意义（P<0.05）;CE-T₁＿fl2d序列对于3～10 mm肺癌脑转移瘤检出率低于CE-T₁＿MPRAGE和CE-T₁＿SPACE序列（分别为87.0%、98.0%、100.0%）,差异有统计学意义（P<0.05）。CE-T₁＿fl2d、CE-T₁＿MPRAGE和CE-T₁＿SPACE序列脑凸面表浅区（分别为62.2%、91.1%、100.0%）、灰白质交界区（分别为79.7%、94.6%、100.0%）的检出率依次升高，差异有统计学意义（P<0.05）;CE-T₁＿fl2d、CE-T₁＿MPRAGE序列对于小脑及脑干区转移灶检出率低于CE-T₁＿SPACE序列（分别为46.4%、60.7%、92.9%）,差异有统计学意义（P<0.05）;CE-T₁＿fl2d序列对于基底节区检查率低于CE-T₁＿SPACE序列（分别为66.7%、95.8%）,差异有统计学意义（P<0.05）。结论 CE-T₁＿SPACE序列对肺癌脑转移瘤病灶检出率优于CE-T₁＿fl2d、CE-T₁＿MPRAGE序列，尤其是<3 mm、脑凸面表浅区、灰白质交界区、小脑及脑干区转移灶，值得临床推广应用。更多还原

【Abstract】 Objective To explore the application value of the variable flip angle fast spin echo T₁ contrast-enhanced sequence（CE-T₁＿SPACE） in the detection of brain metastases from lung cancer.Methods A total of 45 patients with lung cancer and brain metastases who underwent 3.0 T MRI scans in Xinyang Central Hospital from January 2022 to September 2024 were selected. The patients underwent MRI plain scans and three contrast-enhanced T₁ sequences: contrast enhancement fast low-angle shot 2-dimension（CE-T₁＿fl2d）, contrast enhancement magnetization prepared rapid gradient echo（CE-T₁＿MPRAGE）, and contrast enhancement sampling perfection with application optimized contrasts by using different flip angle evolution（CE-T₁＿SPACE）. Two senior radiologists interpreted the MRI images, measured the maximum diameter of the metastatic lesions, classified all lesions into <3 mm, 3-10 mm, and >10 mm, and recorded the lesion locations. The detection rates of brain metastases from lung cancer in different sizes and locations were compared among the three sequences.Results The detection rates of brain metastases from lung cancer using CE-T₁＿fl2d, CE-T₁＿MPRAGE, and CE-T₁＿SPACE sequences increased sequentially（70.0%, 89.7%, and 99.0%, respectively）, with statistically significant differences（P<0.05）. The detection rates for lesions <3 mm in diameter also increased sequentially among CE-T₁＿fl2d, CE-T₁＿MPRAGE, and CE-T₁＿SPACE（45.2%, 78.6%, and 97.6%, respectively）, with statistically significant differences（P<0.05）. The detection rate of CE-T₁＿fl2d for lesions 3-10 mm in diameter was lower than that of CE-T₁＿MPRAGE and CE-T₁＿SPACE（87.0%, 98.0%, and 100.0%, respectively）, with statistically significant differences（P<0.05）. The detection rates in the superficial convexity and gray-white matter junction areas increased sequentially among CE-T₁＿fl2d, CE-T₁＿MPRAGE, and CE-T₁＿SPACE（62.2%, 91.1%, and 100.0% for the convexity; 79.7%, 94.6%, and 100.0% for the gray-white matter junction, respectively）, with statistically significant differences（P<0.05）. The detection rates of CE-T₁＿fl2d and CE-T₁＿MPRAGE for metastatic lesions in the cerebellum and brainstem were lower than that of CE-T₁＿SPACE（46.4%, 60.7%, and 92.9%, respectively）, with statistically significant differences（P<0.05）. The detection rate of CE-T₁＿fl2d for lesions in the basal ganglia was lower than that of CE-T₁＿SPACE（66.7%, 95.8%, respectively）, with a statistically significant difference（P<0.05）.Conclusion The CE-T₁＿SPACE sequence has a higher detection rate for brain metastases from lung cancer compared to CE-T₁＿fl2d and CE-T₁＿MPRAGE, especially for lesions <3 mm in diameter and those located in the superficial convexity, gray-white matter junction, cerebellum, and brainstem. Therefore, CE-T₁＿SPACE is worthy of clinical promotion and application.更多还原