1.5T MR3D-SPACE序列在膝关节半月板损伤中的诊断价值

发布时间：2018-03-09 15:57

  本文选题：各项同性　切入点：膝关节　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的运用1.5T磁共振扫描膝关节,通过3D-SPACE(三维快速自旋回波序列)扫描得出的各项同性数据,多平面重组观察半月板,得出诊断结果。常规2D SE扫描序列得出的图像诊断半月板损伤,比较两者在半月板损伤中的诊断价值,以及在半月板分级诊断中的准确率。方法在膝关节半月板损伤病人检查时,常规SE序列扫描同时加做3D-SPACE序列,所有病例均进行常规2D-FSE序列,包括冠状位、矢状位、轴位2D-FSE序列,以及3D-SPACE(三维快速自旋回波序列)序列,并进行膝关节镜检查,来评价半月板损伤的情况。观察两种扫描方法得出的图像,分别记录其诊断结果,以膝关节镜检查为金标准,比较两种扫描方法在半月板损伤中的诊断符合率,探讨3D-SPACE序列在半月板损伤分级诊断中的应用价值。结果1、3D-SPACE(三维快速自旋回波序列)序列诊断半月板损伤的特异度为95.92%、敏感度为90.57%、阳性预测值为96%、阴性预测值为98%、准确率为95%。2D序列诊断半月板损伤的特异度为92%、敏感度为92.16%、阳性预测值为94%、阴性预测值为96%、准确率为93%。3D-SPACE序列和2D常规扫描序列在半月板损伤中诊断符合率分别为95%和93%,用卡方检验进行比较两种序列在半月板损伤的诊断符合率,X2=0.355,P0.05,差异没有统计学意义。2、3D-SPACE(三维快速自旋回波序列)序列获得的各项同性数据,可以进行多平面重组观察,因此可以将半月板损伤的微小细节显示的比较清楚,减少了由于部分容积效应带来的比较模糊的关节损伤,可以更好的显示半月板周围的细小结构的关系,对于常规2D序列因部分容积效应不能明确分级的Ⅱ、Ⅲ级信号可以更好的显示。用卡方检验进行比较两者的诊断准确率,X2=0.024,P0.05,差异有统计学意义,可以认为3D-SPACE较2D-FSE序列在半月板损伤分级诊断中准确率更高。结论3D-SPACE序列作为一种新的MR成像技术,能够快速采集达到各项同性的高分辨率图像,通过多平面重组观察,可以更为准确的显示半月板的解剖结构及周围微小结构,对于1毫米以下的半月板损伤仍然能十分清楚的显示。3D-SPACE与常规序列在诊断半月板损伤中具有相似的诊断能力,但在明确半月板损伤分级诊断中具有较明显的优势,对于是否达到关节镜的手术指证提供更多的影像学依据,术前定位更加准确,在诊断膝关节半月板损伤中具有潜在的应用价值。
[Abstract]:Objective to use 1.5T magnetic resonance imaging (MRI) to scan knee joint and observe meniscus by 3D-SPACE (3D fast spin echo sequence). The diagnostic results were obtained. The conventional 2D SE scan sequence was used to diagnose meniscus injury, and the diagnostic value of them in meniscus injury was compared. Methods the routine SE sequence and 3D-Space sequence were performed simultaneously in the diagnosis of meniscus injury of knee joint. All cases were performed 2D-FSE sequence, including coronal, sagittal and axial 2D-FSE sequences. And 3D-SPACE3 (3D fast spin echo sequence) sequence and knee arthroscopy were performed to evaluate the meniscus injury. The images obtained by the two scanning methods were observed, and the diagnostic results were recorded respectively, and the knee arthroscopy was regarded as the gold standard. The diagnostic coincidence rate of two scanning methods in meniscus injury was compared. To explore the application value of 3D-Space sequence in the diagnosis of meniscus injury classification. Results the specificity, sensitivity, positive predictive value and negative predictive value of 3D-SPACE3D-SPACE sequence in the diagnosis of meniscus injury were 95.92, 90.57, 96 and 98, respectively. The specificity, sensitivity, positive predictive value, negative predictive value and accuracy of 95.2D sequence for the diagnosis of meniscus injury were 92. 16, 92. 16, 94, 96, 933 and 95%, respectively. The diagnostic coincidence rate of the two sequences in meniscus injury was compared by chi-square test. The difference was not statistically significant. The difference was not statistically significant. It is possible to perform multiplanar reconfiguration observations, so that the minute details of meniscus injuries can be shown more clearly, reducing the blur of joint damage due to partial volumetric effects. The relationship between the small structures around the meniscus can be better displayed. For the 鈪，

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