首页|MR 3D-SPACE及2D-FSE技术在膝关节半月板损伤中的诊断效能

MR 3D-SPACE及2D-FSE技术在膝关节半月板损伤中的诊断效能

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目的 探讨MR三维可变反转角快速自旋回波(3D-SPACE)及二维快速自旋回波(2D-FSE)技术在膝关节半月板损伤中的诊断效能。方法 收集因膝关节疼痛、外伤拟行膝关节镜检查的100例患者的影像资料,均进行关节镜检查、常规2D-FSE序列及3D-SPACE序列检查。将关节镜检查结果作为金标准,观察2种MR序列的半月板损伤分级、Ⅲ级损伤形态的分级,统计其诊断半月板损伤的诊断效能,对比其半月板组织对比噪声比(CNR)。结果 经关节镜检查发现,100例疑似膝关节半月板损伤的患者中,92例半月板损伤,58例Ⅲ级半月板损伤。3D-SPACE序列分级诊断准确性(95。65%)显著优于2D-FSE序列分级诊断准确性(80。43%)(P<0。05),其中3D-SPACE序列Ⅱ级诊断准确性(96。15%)和Ⅲ级诊断准确性(94。83%)显著高于2D-FSE序列Ⅱ级(76。92%)和Ⅲ级(81。03%)(P<0。05)。3D-SPACE序列混合型撕裂诊断准确性(94。74%)显著优于2D-FSE序列(63。16%)(P<0。05)。经一致性分析证实,2D-FSE序列和3D-SPACE序列对半月板损伤总体检出的敏感度、特异度、阳性预测值、阴性预测值、准确性分别为78。26%、75。00%、97。30%、23。08%、78。00%(Kappa值=0。262)和94。57%、87。50%、98。86%、58。33%、94。00%(Kappa值=0。646)(P<0。05)。3D-SPACE序列半月板/韧带CNR高于2D-FSE序列(P<0。05)。结论 3D-SPACE序列在膝关节半月板损伤的诊断中具有较高的敏感度和准确性,且在明确半月板损伤分级及部分撕裂术前定位上有着显著优势,可为疑似膝关节半月板损伤患者诊治提供更为可靠的依据。
Diagnostic efficacy of MR 3D-SPACE and 2D-FSE techniques in knee meniscus injury
Objective To explore the diagnostic efficacy of MR with three-dimensional sampling perfection with application opti-mized contrast using different flip angle evolutions(3D-SPACE)and two-dimensional fast spin echo(2D-FSE)techniques in knee meniscus injury.Methods The imaging data of 100 patients who underwent arthroscopy for knee pain or trauma were collected.All patients underwent arthroscopy,conventional 2D-FSE sequence and 3D-SPACE sequence examination.Using the results of arthroscopy as the gold standard,the classification of meniscus injury and the classification of grade Ⅲ injury morphology were observed in two MR sequences.The diagnostic efficacy of meniscus injury was measured,and the contrast-to-noise ratio(CNR)of meniscus tissue was compared.Results Arthroscopy revealed 92 meniscus injury,and 58 grade Ⅲ meniscus injury,among 100 patients with suspected knee meniscus injury.The accuracy of classification diagnosis with the 3D-SPACE sequence(95.65%)was significantly better than that of the 2D-FSE sequence classification diagnosis acuracy(80.43%)(P<0.05).Specifically,the diagnostic accuracy of gradeⅡ(96.15%)and grade Ⅲ(94.83%)with the 3D-SPACE sequence was significantly higher than that of the 2D-FSE sequence(76.92%for grade Ⅱ and 81.03%for grade Ⅲ)(P<0.05).The diagnostic accuracy of mixed-type tears with the 3D-SPACE sequence(94.74%)was significantly better than that of the 2D-FSE sequence(63.16%)(P<0.05).Consistency analysis confirmed that the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of the 2D-FSE and 3D-SPACE sequences for overall detec-tion of meniscus injury were 78.26%,75.00%,97.30%,23.08%and 78.00%(Kappa value=0.262)and 94.57%,87.50%,98.86%,58.33%,94.00%(Kappa value=0.646)(P<0.05),respectively.The meniscus/ligament CNR of the 3D-SPACE sequence was higher than that of the 2D-FSE sequence(P<0.05).Conclusion The 3D-SPACE sequence exhibits high sensitivity and accuracy in the diagnosis of knee meniscus injury.It has significant advantages in determining the classification of meniscus injury and preoperative location of partial tears,providing a more reliable basis for the diagno-sis and treatment of patients with suspected knee meniscus injury.

knee meniscus injurythree-dimensional sampling perfection with application optimized contrast using different flip angle evolutionstwo-dimensional fast spin echoarthroscopy

刘刚、李鹏、邬玉芹、黄巍

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长沙市第一医院放射科,湖南 长沙 410005

膝关节半月板损伤 三维可变反转角快速自旋回波 二维快速自旋回波 关节镜

2025

实用放射学杂志
西安市医学科学研究所

实用放射学杂志

北大核心
影响因子:1.141
ISSN:1002-1671
年,卷(期):2025.41(1)