膝关节半月板损伤的磁共振诊断:三维质子加权序列与二维序列的对比

发布时间：2018-05-15 05:40

本文选题：膝关节 + 半月板　；参考：《临床放射学杂志》2015年01期

【摘要】：目的比较评估三维快速自旋回波(3D-SPACE)序列与传统二维快速自旋回波(2D-TSE)序列对于膝关节半月板损伤的诊断价值。方法半月板撕裂病例共40例。对所有患者进行3D-SPACE序列及2D序列的扫描,根据所得图像对半月板撕裂进行分型诊断。分别计算半月板信噪比(SNR)、半月板/软骨对比噪声比(CNR)、半月板/韧带CNR、半月板/关节液CNR,比较两者是否有统计学差异;与关节镜或手术结果比较,计算诊断半月板撕裂的敏感度、特异度、阳性预测值、阴性预测值及准确率,比较两者诊断符合率是否有统计学差异。结果 3D序列对于复合撕裂的诊断准确率较高。两种序列所得图像半月板SNR间差异无统计学意义(P=0.736);两种序列所得图像半月板/软骨CNR差异无统计学意义(P=0.526),半月板/韧带CNR差异有统计学意义(P=0.029),半月板/关节液CNR差异无统计学意义(P=0.899)。3D-PD-SPACE序列采集所得图像Kappa值为0.84,表示不同观察者之间具有较强的一致性。两种序列在诊断半月板撕裂的准确性上没有明显差异(P=0.5760.05)。结论3D-SPACE序列是一种新的MR成像序列,能进行各向同性的扫描及多平面薄层重组,对于某些半月板撕裂类型诊断准确性较高,在膝关节半月板损伤的诊断方面有潜在应用价值。
[Abstract]:Objective to evaluate the diagnostic value of 3D fast spin-echo 3D-SPACE-3D-SPACE-2D-TSEsequence in meniscus injury of knee joint. Methods 40 cases of meniscus tear were treated. All patients were scanned with 3D-SPACE sequence and 2D sequence. The signal-to-noise ratio (SNR) of meniscus, the ratio of meniscus / cartilage contrast noise, CNRR, CNRand CNR of meniscus / articular fluid were calculated respectively, and the sensitivity of diagnosis of meniscus tear was calculated compared with the results of arthroscopy or surgery. Specificity, positive predictive value, negative predictive value and accuracy were compared. Results the diagnostic accuracy of 3 D sequence for complex tear was higher than that of 3 D sequence. There was no significant difference in meniscus SNR between the two sequences, but there was no significant difference in meniscus / cartilage CNR, meniscus / ligament CNR and meniscus / articular fluid CNR in the meniscus / articular fluid of the two sequences. The difference was not statistically significant. The Kappa value of the images collected by PX 0.899 + .3D-PD-Space sequence was 0.84, which indicated that there was strong consistency among different observers. There was no significant difference between the two sequences in the diagnosis of meniscus tear. Conclusion 3D-SPACE sequence is a new Mr imaging sequence, which can perform isotropic scanning and multiplanar thin-layer recombination, and has high diagnostic accuracy for some meniscus tear types, and has potential application value in the diagnosis of meniscus injury of knee joint.
【作者单位】：南京中医药大学附属医院放射科;南京医科大学第一附属医院放射科;
【分类号】：R684;R445.2

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