ේ⪺
⣶ᬁ MRI ߦ߅ߌࠆ⚻ᩮឬߩᬌ⸛
ᚲ⾆ੳ ႐ว⟤ᄹሶ ⿒ဈᱜ ጊญஜੑ ਃ◊ ਅᲞ ⷺᒄ⻀ 㧕ᕺኼ✚ว∛㒮 ✢ㇱ ✢⺖㧕ᕺኼ✚ว∛㒮 ✢ㇱ ޣⷐᣦޤ ᬁ㑆ሹㇱߩ⹏ଔߦߪ MR-myelography ߇↪ߢࠆߣߩႎ๔߇ࠅ㧘ㅢᏱ Balanced ࠪࠤࡦࠬ㧔ᒰ㒮ߢ ߪ true steady state free precession㧦true SSFP㧕߇↪ࠄࠇߡࠆޕBalanced ࠪࠤࡦࠬߩାภᒝᐲߪ⚵ ❱ߩ T1㧘T2 ୯ߩᲧߦࠃࠅቯߐࠇ㧘T2/T1 ୯߇Ყセ⊛ᄢ߈ߥ୯ࠍߣࠆ㜑ᶧ߿ⴊᶧ㧘⢽⢌ߥߤߪ㜞ାภࠍ๒ ߔࠆޕߒ߆ߒ㧘㜑ᶧ߿ⴊᶧ߇㕖Ᏹߦᒝ㜞ାภߣߒߡឬߐࠇߡઁߩ⚵❱ߩାภ߇⋧ኻ⊛ߦૐਅߔࠆߚ㧘 エㇱ⚵❱ߩࠦࡦ࠻ࠬ࠻߇ૐߊ㧘ᬁ㑆ሹㇱ߿ߘߩ㆙ߢࠆᬁ㑆ሹᄖㇱߩ⣶ᬁ⚻ᩮߩឬߪ⍎ߢߪߥޕ ߘߎߢ㧘エㇱ⚵❱ࠦࡦ࠻ࠬ࠻ߩᡷༀߣᬁ㑆ሹᄖㇱߩ⣶ᬁ⚻ᩮࠍ⍎ߦឬߔࠆߎߣࠍ⋡⊛ߣߒߡ㧘true SSFPߣ three dimential-field echo㧔3D-FE_fc㧕ᴺߩ 2 ⒳㘃ߩࠪࠤࡦࠬߢ㧘flip angle (FA)ࠍ 10 ᐲ߆ࠄ 60ᐲ߹ߢ 10 ᐲᲤߦᄌൻߐߖߡ᧦ઙߩᬌ⸛ࠍⴕߞߚޕࡏࡦ࠹ࠖࠕߦ߅ߌࠆᬌ⸛ߢ㧘⣶ᬁ⚻ᩮߩឬ⢻ߪାภᒝᐲߩૐਅ߇ዊߐ 3D-FE_fc ᴺߩ FA10 ᐲ߇ᦨ߽ఝࠇߡߚޕtrue SSFP ߪ⣄㜑ᶧߩᒝ㜞ାภൻߣⴊᵹߩㆃᬁ࿐㕒⣂ߩ㜞ାภ߇㓚ኂ㒶ᓇߣ ߥࠅ㧘⣶ᬁ⚻ᩮߩឬࠍૐਅߐߖࠆⷐ࿃ߦߥߞߚߣ⠨߃ࠆޕ3D-FE_fc ᴺߩ MR-myelography ࠍㅢᏱߩ⣶ ᬁ MRI ᬌᩏߦㅊടߔࠆߎߣߢ㧘⚻ᩮ㆙ㇱ∛ᄌߩ⸻ᢿ₸߇ะߒ㧘far-out syndrome ߿ᄖဳᬁ㑆᧼ࡋ ࡞࠾ࠕ߇ᄙߊߟ߆ࠆน⢻ᕈ߇ࠆߣ⠨߃ࠆޕ
Key Words㧦MR ࡒࠛࡠࠣࡈࠖ㧘⣶ᬁ⚻ᩮ㧘⣶ᬁᬁ㑆ሹ⁜⓰∝
ޣߪߓߦޤ
ㄭᐕ㧘magnetic resonance imaging(MRI)ߩ৻ ᴺߢࠆ Balanced ࠪࠤࡦࠬߪ㧘㜞ㅦߢ㜞 ାภ㔀㖸Ყ㧔signal-to-noise ratio㧦SNR㧕ࠍᓧࠆߎ ߣ߇ߢ߈ࠆߚߦ㧘ߐ߹ߑ߹ߥ㗔ၞߢ⥃ᐥ↪ߐࠇ ߡࠆޕᬁ㑆ሹㇱߩ⹏ଔߦߪ MR-myelography ߇ ↪ߢࠆߣߩႎ๔߇ࠅ㧘ㅢᏱ Balanced ࠪࠤࡦ ࠬ㧔ᒰ㒮ߢߪ true steady state free precession㧦true SSFP㧕߇↪ࠄࠇߡࠆޕBalanced ࠪࠤࡦࠬߩ ାภᒝᐲߪ⚵❱ߩ T1㧘T2 ୯ߩᲧߦࠃࠅቯߐࠇ㧘 T2/T1୯߇Ყセ⊛ᄢ߈ߥ୯ࠍߣࠆ㜑ᶧ߿ⴊᶧ㧘⢽⢌ ߥߤߪ㜞ାภࠍ๒ߔࠆޕߒ߆ߒ㧘㜑ᶧ߿ⴊᶧ߇㕖Ᏹ ߦᒝ㜞ାภߣߒߡឬߐࠇߡઁߩ⚵❱ߩାภ߇⋧ ኻ⊛ߦૐਅߔࠆߚ㧘エㇱ⚵❱ߩࠦࡦ࠻ࠬ࠻߇ૐ ߊ㧘ᬁ㑆ሹㇱ߿ߘߩ㆙ߢࠆᬁ㑆ሹᄖㇱߩ⣶ᬁ ⚻ᩮߩឬߪ⍎ߢߪߥ1,2)ޕ⣶ᬁ⚻ᩮߩⴕ߿ ᄖ∛ᄌࠍ⍎ߦឬߔࠆߎߣߪ⥃ᐥ⊛ߦ↪ߢ ࠅ㧘⣶ᬁ⚻ᩮ∝ߦኻߔࠆᚻⴚᚑ❣ߦ߽ᓇ㗀ࠍ߷ ߔ3,4)ޕߘߎߢ㧘エㇱ⚵❱ࠦࡦ࠻ࠬ࠻ߩᡷༀߣᬁ㑆 ሹᄖㇱߩ⣶ᬁ⚻ᩮࠍ⍎ߦឬߔࠆߎߣࠍ⋡⊛ߣ ᬌ⸛ࠍⴕߞߚޕ ޣኻ⽎ߣᣇᴺޤ ↪ᯏེߪ㧘TOSHIBA ␠ 1.5 T MRI ⵝ⟎㧦 EXCELART Vantage XGV F2-Edition Ver.8.02ߣ ⣄ᬁ↪ࠦࠗ࡞㧦CTL array coil ࠍ↪ߚޕᧄ⎇ⓥߦ หᗧ߇ᓧࠄࠇߚஜᏱࡏࡦ࠹ࠖࠕ 4 ฬ(ᐔဋ 29.8 ᱦ) ࠍኻ⽎ߣߒߡ㧘true SSFP ߣ 3D-FE_fc ᴺߩ 2 ⒳㘃 ߩࠪࠤࡦࠬߢ㧘flip angle (FA)ࠍ 10 ᐲ߆ࠄ 60 ᐲ ߹ߢ 10 ᐲᲤߦᄌൻߐߖߡ coronal ᢿ㕙ߦߡࠍⴕ ߞߚޕ
true SSFP ߩ FA એᄖߩࡄࡔ࠲ߪ㧘 TR:14.7 ms㧘TE:7.2 ms㧘ࠬࠗࠬෘ㧦2.0 mm㧘 matrix㧦224×224㧘field of view (FOV)㧦30×30 cm 㧘ട▚࿁ᢙ㧦2㧘⢽⢌ᛥᴺ㧦CHESS ᴺ㧘ࡃࡦ࠼ 㧦244 Hz/pixel㧘ࠬࠗࠬᨎᢙ㧦25 ᨎ㧘ᤨ㑆㧦 2 min 58 sߣߒߚޕ
3D-FE_fc ᴺߩ FA એᄖߩࡄࡔ࠲ߪ㧘 TR:34.8ms㧘TE:10ms㧘ࠬࠗࠬෘ㧦2.0 mm㧘matrix 㧦224×224㧘field of view (FOV)㧦30×30 cm㧘ട▚
sߣߒߚޕ エㇱ⚵❱ࠦࡦ࠻ࠬ࠻ߣ⣶ᬁ⚻ᩮߩឬ⢻ࠍᬌ ⸛ߔࠆߚߦ㧘ࡏࡦ࠹ࠖࠕ↹ࠍ↪ߡฦ⚵❱ࠦ ࡦ࠻ࠬ࠻⹏ଔߣ⣶ᬁ⚻ᩮߩାภᒝᐲ᷹ቯ߅ࠃ߮ ⸻≮✢ᛛᏧߦࠃࠆⷞⷡ⹏ଔࠍⴕߞߚޕ⚵❱ࠦࡦ ࠻ࠬ࠻᷹ቯߪ⣄㜑ᶧ㧘⚻ᩮ㧘ᬁ㑆᧼㧘⣺⣶╭㧘 ᬁߦߘࠇߙࠇ 5 ߩ ROI ࠍ⸳ቯߒ㧘ߘࠇߙࠇߩା ภߩᐔဋ୯ࠍ᷹ቯߒߚ㧔࿑ 1㧕ޕߎߎߢߩ ROI ߩᄢ ߈ߐߪ 16 pixel ߣߒߚޕߘߒߡ↹㧘ାภᒝᐲߩ ૐ⣄ᬁߦኻߔࠆߘߩઁߩ⚵❱ࠦࡦ࠻ࠬ࠻Ყࠍએ ਅߩᑼߢ▚ߒߚޕ
ࠦࡦ࠻ࠬ࠻=|(SIT㧙SIBG)㨨/㨧 (SIT+SIBG)/2㨩
ߎߎߢ㧘SITߪฦ⚵❱ߩᐔဋାภᒝᐲ㧘SIBGߪ⣄ᬁ ߩᐔဋାภᒝᐲߢࠆޕ ᰴߦ⣶ᬁ⚻ᩮߩାภᒝᐲ᷹ቯߪ㧘⣶ᬁ⚻ᩮߩ ㄭㇱ㨪㆙ㇱߦ߆ߌߡ 8 ࡨᚲߦ ROI ࠍ⸳ቯߒ㧘ߘ ߩᐔဋାภᒝᐲࠍ᷹ቯߒߚޕߎߎߢߩ ROI ߩᄢ߈ߐ ߪ 16 pixel ߣߒߚޕ ޣ⚿ᨐޤ ฦࡏࡦ࠹ࠖࠕߦ߅ߌࠆ true SSFP ߩ⣄ᬁߦኻ ߔࠆฦ⚵❱ߩࠦࡦ࠻ࠬ࠻ࠍ࿑ 2 ߦ㧘3D-FE_fc ᴺ ߩ⣄ᬁߦኻߔࠆฦ⚵❱ߩࠦࡦ࠻ࠬ࠻ࠍ࿑ 3 ߦ␜ߔ ޕtrue SSFP ߢߪ FA ߇ᄢ߈߶ߤ⣄㜑ᶧߩࠦࡦ࠻ ࠬ࠻߇ߒߚޕ߹ߚࡏࡦ࠹ࠖࠕ㑆ߩ߫ࠄߟ߈ ߪߞߚ߇㧘FA ᄌൻߦ߅ߌࠆ⚻ᩮ㧘ᬁ㑆᧼ߩࠦ ࡦ࠻ࠬ࠻ߪ߶߷ᮮ߫㧘⣺⣶╭ߩࠦࡦ࠻ࠬ࠻ߪ FA߇ᄢ߈ߊߥࠆߣ⧯ᐓૐਅߒߚޕ3D-FE_fc ᴺߢߪ 㧘⣄㜑ᶧߩࠦࡦ࠻ࠬ࠻ߪ FA=10 ᐲ߆ࠄ 30 ᐲߩ㑆 ߢᕆỗߦૐਅߒߚޕ߹ߚ㧘⚻ᩮ㧘ᬁ㑆᧼㧘⣺⣶╭ ߩࠦࡦ࠻ࠬ࠻ߪࡏࡦ࠹ࠖࠕ㑆ߩ߫ࠄߟ߈߇ᄢ߈ ߆ߞߚޕ FA ᄌൻߦ߅ߌࠆ⣶ᬁ⚻ᩮߩㄭ߆ࠄ㆙ߦ߆ ߌߡߩᐔဋାภᒝᐲࠍ࿑ 4 ߦ␜ߔޕtrue SSFP ߢߪ ⣶ᬁᬁ㑆ሹㇱߢᕆỗߦାภᒝᐲ߇ૐਅߒ㧘ᧃ᪳߳ะ ߆߁ߦᓥߐࠄߦାภᒝᐲ߇ૐਅߒߚޕ߹ߚ㧘ዊߐ FA ߶ߤ⣶ᬁ⚻ᩮߩାภᒝᐲߪ㜞߆ߞߚޕ 3D-FE_fcᴺߪ㧘ዊߐ FA ߢߪ⣶ᬁ⚻ᩮㄭ߆ࠄ ㆙ߦ߆ߌߡૐਅ߇ࠄࠇߚ߇㧘true SSFP ߦᲧߴ ߡାภᒝᐲߩૐਅߪዊߐ߆ߞߚޕ ฦࡏࡦ࠹ࠖࠕߩ↹ࠍ࿑ 5㧘6 ߦ␜ߔࠆޕtrue SSFPߢߪᄢ߈ߥ FA ߢ⣄㜑ᶧߩାภᒝᐲ߇㜞ߊ㧘 ⣶ᬁ⚻ᩮߩឬ⢻ߣエㇱ⚵❱ࠦࡦ࠻ࠬ࠻߇ૐਅ ߒߚޕFA ࠍ 30 ᐲઃㄭ߹ߢዊߐߊߔࠆߣ⣄㜑ᶧߩା ภࠍᛥ߃ࠆߎߣ߇ߢ߈㧘⣶ᬁ⚻ᩮߩឬ⢻ߣエㇱ ⚵❱ࠦࡦ࠻ࠬ࠻߇ᡷༀߒߚޕ3D-FE_fc ᴺߢߪ㧘 FA ߇ᄢ߈ߊߥࠆߦߟࠇߡ⣄㜑ᶧߩାภᒝᐲ߇ࠄ ߆ߦૐਅߒ㧘FA=40 ᐲએߢエㇱ⚵❱ࠦࡦ࠻ࠬ࠻ ߇ૐਅߒߚޕᬁ㑆ሹᄖㇱߩ⣶ᬁ⚻ᩮߩឬ⢻ߪዊ ߐ FA ߇ఝࠇߡߚޕ ࿑ 1 ฦ⚵❱ߦ߅ߌࠆ ROI ⸳ቯ ⣄㜑ᶧ㧘⚻ᩮ㧘ᬁ㑆᧼㧘⣺⣶╭㧘ᬁߦߘࠇߙࠇ 5 ߩ ROI ࠍ⸳ቯߒ㧘ᐔဋ୯ࠍ▚
⬨᳝䛻ᑐ䛩䜛ྛ⤌⧊䛾
ಙྕᙉᗘ䜢 ᐃ
⬨᳝ࡢᖹᆒಙྕ್
ྛ⤌⧊ࡢᖹᆒಙྕ್
:
:
BG TSI
SI
2
/
)
(
)
(
BG T BG TSI
SI
SI
SI
ࢥࣥࢺࣛࢫࢺ
⤌⧊㛫 ᐃἲ
࿑ 2 true SSFP ߦ߅ߡฦࡏࡦ࠹ࠖࠕ↹ߩ FA ᄌൻߦࠃࠆฦ⚵❱ࠦࡦ࠻ࠬ࠻ᄌൻ ࿑ 3 3D-FE_fc ᴺߦ߅ߡฦࡏࡦ࠹ࠖࠕ↹ߩ FA ᄌൻߦࠃࠆฦ⚵❱ࠦࡦ࠻ࠬ࠻ᄌൻ
true SSFPἲ
䝁䞁䝖䝷䝇䝖 䝁䞁䝖䝷䝇䝖 䝁䞁䝖䝷䝇䝖 䝁䞁䝖䝷䝇䝖FA
FA
FA
FA
䝪䝷䞁䝔䜱䜰A 䝪䝷䞁䝔䜱䜰C 䝪䝷䞁䝔䜱䜰D3D-FE_fcἲ
䝁䞁䝖䝷䝇䝖 䝁䞁䝖䝷䝇䝖 䝁䞁䝖䝷䝇䝖 䝁䞁䝖䝷䝇䝖FA
FA
䝪䝷䞁䝔䜱䜰A 䝪䝷䞁䝔䜱䜰B 䝪䝷䞁䝔䜱䜰C 䝪䝷䞁䝔䜱䜰D࿑ 4 true SSFP ߣ 3D-FE_fc ᴺߦ߅ߡ FA ߩ㆑ߦࠃࠆ⣶ᬁ⚻ᩮㄭ㨪㆙ߦ߆ߌߡߩାภᒝᐲᄌൻ ࿑ 5 true SSFP ߩ FA ᄌൻߦ߅ߌࠆ⣶ᬁ↹
⭜᳝⚄⤒᰿䛾ಙྕᙉᗘ
⭜᳝⚄⤒᰿㏆䡚㐲䛻
䛛䛡䛶ROI䜢䛸䜚䚸䛭䛾ᖹᆒ
ಙྕᙉᗘ䜢ィ
true SSFP
㏆ 㐲 ㏆ 㐲 ᖹᆒಙྕᙉᗘ ᖹᆒಙྕᙉᗘtrue SSFP
FA=50
FA=10
FA=20
FA=60
FA=30
FA=40
࿑ 6 3D-FE_fc ᴺߩ FA ᄌൻߦ߅ߌࠆ⣶ᬁ↹ ޣ⠨ኤޤ ⣄ᬁ⣄㜑ߦ߅ߌࠆ MRI ᬌᩏߪ㧘ߘߩ㜞⚵❱ ࠦࡦ࠻ࠬ࠻߆ࠄ㕖ଚⷅ⊛ߥᬌᩏᴺߣߒߡᐢߊ ↪ߐࠇߡ߅ࠅ㧘⣶ᬁ∔ᖚߩ⸻ᢿߦኻߒߡ߽ᔅⷐਇน ᰳߥᬌᩏߣߥߞߡࠆޕߒ߆ߒ㧘ߩ MRI ߢߩ ㅢᏱߢߪ⚻ᩮߩឬߦ㒢⇇߇ࠆߣߩ⸃߽ ࠆ 5~7)ޕߘߩߚ㧘エㇱ⚵❱ࠦࡦ࠻ࠬ࠻ߩᡷༀ ߣ ⣶ ᬁ ⚻ᩮ ߩ ㆙ ㇱឬ ࠍ ⋡ ⊛ߣ ߒ ߡ 㧘 true SSFPߣ 3D-FE_fc ᴺߩ 2 ⒳㘃ߩࠪࠤࡦࠬߢ ᧦ઙߩᬌ⸛ࠍⴕߞߚޕ ࡏࡦ࠹ࠖࠕߦ߅ߌࠆᬌ⸛ߢ㧘⣶ᬁ⚻ᩮߩ ឬ⢻ߪାภᒝᐲߩૐਅ߇ዊߐ 3D-FE_fc ᴺߩ FA=10ᐲ߇ᦨ߽ఝࠇߡߚޕߎࠇߪฦ⚵❱ߩ❑✭ ߩ㆑㧘ߔߥࠊߜ 3D-FE_fc ᴺߢߪ FA ߇ዊߐ߶ ߤ❑✭߇ᣧߊ࿁ᓳߔࠆߩߢ㧘⣄㜑ᶧ߅ࠃ߮⣶ᬁ ⚻ᩮߩࠦࡦ࠻ࠬ࠻߇㜞ߊߥߞߚߣ⠨߃ࠆޕ৻ᣇ㧘 true SSFPߪቯᏱ⁁ᘒㇱߩ࠺࠲ࠍ↪ࠆߚ㧘⍴ ᤨ㑆ߢ heavy T2 ᒝ⺞ࠍᓧࠆߎߣ߇ߢ߈㧘ߘߩ↹ ߢᕆỗߦ⣶ᬁ⚻ᩮߩାภᒝᐲ߇ૐਅߒߚޕߎࠇߪ ⣶ᬁᬁ㑆ሹㇱߢ⣶ᬁ⚻ᩮ߇ 2 ᧄߩ⚻▵ߦಽ߆ࠇ ߚߚߣ⠨߃ࠆޕ߹ߚ㧘true SSFP ߪ⣄㜑ᶧߩᒝ 㜞ାภൻߣⴊᵹߩㆃᬁ࿐㕒⣂ߩ㜞ାภ߇㓚ኂ 㒶ᓇߣߥࠅ㧘⣶ᬁ⚻ᩮߩឬࠍૐਅߐߖࠆⷐ࿃ߦ ߥߞߚߣ⠨߃ࠆޕ3D-FE_fc ᴺߪߎࠇࠄߩ㜞ାภㇱ ಽߦኻߔࠆ㗴ὐߩᓇ㗀߇ዊߐߊ㧘⦟ᅢߥエㇱ⚵❱ ࠦࡦ࠻ࠬ࠻ߣ⣶ᬁ⚻ᩮ㆙ㇱ߇ឬน⢻ߣߥߞ ߚޕߘߩߚ㧘3D-FE_fc ᴺߩ MR-myelography ࠍ ㅢᏱߩ⣶ᬁ MRI ᬌᩏߦㅊടߔࠆߎߣߢ㧘⚻ᩮ㆙ ㇱ∛ᄌߩ⸻ᢿ₸߇ะߒ㧘far-out syndrome ߿ᄖ ဳᬁ㑆᧼ࡋ࡞࠾ࠕ߇ᄙߊߟ߆ࠆน⢻ᕈ߇ࠆߣ ⠨߃ࠆޕ
FE3D_fc
ἲ
FA=50
FA=10
FA=20
FA=60
FA=30
FA=40
ޣᢥ₂ޤ
1) 㕍↰ᵗ৻㧦⣶ᬁᬁ㑆ሹౝ⁜⓰∝ߦኻߔࠆ MRI ߣ MRࡒࠛࡠߩ⸻ᢿ♖ᐲ㧚ᢛᒻᄖ⑼ 61(1):83-86,2010 2) ၳ ᱜ㧘⍹ᘮ৻㧘ጊญ ᥏㧘ઁ㧚㧦⣄㜑ߩ balanced sequence MRI㧘MR myelography㧚⣄ᬁ ⣄㜑 21(2)㧦123-128, 2008
3) Ross JS. Newer sequence for spinal MR imaging㧦smorgasboad or succotash of acronysm?. AJNR Am J Neuroradiol 20(3)㧦361-373, 1999 4) ੑ㓏ၴ℉㧘⚬㊁ᘅ৻㧦⣶ㇱ⣄ᩇ▤⁜⓰ߩౣᚻⴚ ߩේ࿃ߣ revision ᚻᛛ㧚⣄ᬁ⣄㜑 22(7)㧦835-839, 2009 5) ศᧄਃᓼ㧘ጤἑጪੱ㧘↰ഞ㧘ઁ㧦ᄖဳ⣶ᬁ ᬁ㑆᧼ࡋ࡞࠾ࠕߩ⸻ᢿߣౝⷞ㏜ਅᬁ㑆᧼ಾ㒰ⴚ㧚ᢛ ᒻἴኂᄖ⑼ 52(9)㧦1071-1076, 2009 6) ጊ↰ ብ㧘ศ↰ቬੱ㧘ᧁᚭ⟵ᾖ㧘ઁ㧦⣄㜑⚻ᩮ ߩ 3 ᰴర MRI㧚⣄ᬁ⣄㜑 21(2)㧦115-121, 2008 7) ጤፒ ඳ㧘ศ↰ቬੱ㧘ጊ↰ ብ㧘ઁ㧦Far-out syndrome ߩ ⸻ ᢿ ᴺ 㧚 ᢛ ᒻ ἴ ኂ ᄖ ⑼ 52(9) 㧦 1081-1087, 2009 8) ⼾ᩮ⍮㧘↵Ỉᦺⴕ㧘ᷰㄝᷕ㧦⣶ᬁᬁ㑆ሹ⁜⓰ ߩ↹⸻ᢿ㧚⣄ᬁ⣄㜑 23(5)㧦515-520, 2010
