膝关节透明软骨损伤的MR成像序列比较及与关节镜对照研究

目的　比较抑脂三维梯度回波序列FS -3D -FSPGR和抑脂快速自旋回波T2 WIMR成像序列FS -FSE -PD T2 WI诊断软骨病变的准确性。方法　 2 3例临床病例 ,采用抑脂三维梯度回波序列和抑脂快速自旋回波T2 WIMR成像序列扫描 ,前瞻性分级诊断 184个关节软骨面 ,分别与关节镜分级结果对照。采用双盲法计算出各序列用于诊断软骨缺损的敏感度、特异度和准确度、Kappa值。结果　FS -3D -FSPGR序列诊断软骨损伤的敏感度为 86% ,特异度为 96% ,Kappa值为 0 .80 ;FS -FSE -PD T2 WI序列诊断的敏感度为 46% ,特异度为 99% ,Kappa值为 0 .5 6。结论　附加脂肪抑制的三维梯度回波序列诊断膝关节透明病变的敏感度、准确性高于附加脂肪抑制的快速自旋回波T2 WI,仍为目前诊断软骨病变的最佳扫描序列

Study of Comparing the MR Sequence in Detecting Hyaline Cartilage Defects:Comparing with Arthroscopy

Objective The purpose of this study was to compare the MR imaging sequence for detecting hyaline cartilage defects.Methods 23 patients were evaluated for hyaline cartilage defects of the knee with MR imaging.All these patients underwent arthroscopy.MR imaging protocol included a fat-suppressed three-dimensional fast spoiled gradient-echo sequence(FS-3D-FSPGR),and dualecho fast spin-echo with fat saturation sequence(FS-FSE-PD/T 2) at least.Results A total of 184 articular surfaces were graded.For the detection of cartilage defect with FS-3D-FSPGR sequence,sensitivity was 86%,specificity was 96%,Kappa was 0.80.FS-FSE-PD/T 2 sequence,sensitivity was 46%,specificity was 99%,Kappa was 0.56.Conclusion Sensitivity of FS-3D-FSPGR sequence detecting hyaline cartilage defect is the highest.T 2WI/PDWI of fast spin-echo with fat saturation should be the standard sequence in examination of knee joint.