三维MR影像对前交叉韧带损伤诊断价值的研究  

Evaluation of anterior cruciate ligament ruptures by three dimension MR imaging

作　　者：程瑾[1] 刘霞[1] 杜湘珂[1] 

机构地区：[1]北京大学人民医院放射科,100044

出　　处：《中华放射学杂志》2012年第12期1105-1109,共5页Chinese Journal of Radiology

摘　　要：目的比较常规2D及3D超长回波链采集FSE序列（3DCubeT，WI）MRI对前交叉韧带（ACL）损伤的诊断价值。方法40例膝关节外伤患者先后行常规2DMR及3DCubeT，WIMR检查并分别作出ACL损伤的诊断，包括ACL完整、部分撕裂及完全撕裂。以关节镜检查结果作为ACL损伤的金标准。应用ROC法计算2种影像检查对ACL部分撕裂及完全撕裂诊断的曲线下面积（AUC）值并应用Hanley＆McNeil检验比较两者在统计学上的差异。结果40例经关节镜证实的膝关节损伤患者中，ACL完整者16例，双束完全撕裂为12例，部分撕裂者为12例。对ACL完全撕裂，2DMR的AUC值为0．839，3DCube的AUC值为0．923，两者差异无统计学意义（Z=1．245，P=0．213）；而对于ACL部分撕裂，2DMR的AUC值为0．643，3DCube的AUC值为0．881，两者差异有统计学意义（Z=2．384，P=0．017）。结论常规2DMR及3DCubeMR对ACL完全断裂诊断效力无差异，3DCubeMR对于ACL部分损伤诊断效力优于常规2DMR。Objective To compare the diagnosic performance of conventional 2D and 3D Cube MR imaging to identify complete and partial tears of anterior cruciate ligament（ACL）. Methods Forty patients suspected of having tears of anterior cruciate ligament were prospectively studied by 3.0 T conventional 2D and 3D Cube MR imaging and arthroscopy. MR images were interpreted in consensus by two experienced radiologists, and the ACL was diagnosed as being normal, partially torn, or completely torn. Diagnostic accuracy of 2D and 3D Cube MR for the detection of both complete and partial tears of ACL was calculated using arthroscopy as the standard of reference. Area under curve （AUC） of both methods were calculated using ROC curves and were compared using Hanley＆ McNeil curve comparisions. Results Sixteen patients had intact ACL, 12 had complete tear, and 12 had partial tear of the ACL at arthroscopy. For complete ACL tear, AUC of 2D MR and 3D Cube was 0. 839 and O. 923 respectively, and there was no significant difference on ROC curves （Z = 1. 245 ,P = 0. 213）. For partial ACL tears, AUC of 2D and 3D Cube MR were 0. 643 and 0. 881 respectively, and there was significant difference on ROC curves （Z = 2. 384, P = 0. 017） . Conclusions Both 2D MR and 3D Cube MR have high sensitivity and specificity for identifying the complete ruptures of ACL. 3D Cube MRI appears to be superior inidentifving oartial ruoture of ACL.

关 键 词：前交叉韧带 撕裂伤 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]