MR 3D-SPACE及2D-FSE技术在膝关节半月板损伤中的诊断效能
Diagnostic efficacy of MR 3D-SPACE and 2D-FSE techniques in knee meniscus injury
刘刚 1李鹏 1邬玉芹 1黄巍1
作者信息
- 1. 长沙市第一医院放射科,湖南 长沙 410005
- 折叠
摘要
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.
Abstract
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.
关键词
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Key words
knee meniscus injury/three-dimensional sampling perfection with application optimized contrast using different flip angle evolutions/two-dimensional fast spin echo/arthroscopy引用本文复制引用
出版年
2025
NETL
NSTL
万方数据