多模态MR成像技术对膝关节骨性关节炎软骨损伤的诊断价值  

Diagnostic value of multi-modal MR imaging for cartilage lesion in knee osteoarthritis

作　　者：赵双全[1] 梁久平[1] 彭华荣[1] 宋建勋[1] 吴谦 成官迅[2] ZHAO Shuang-quan;LIANG Jiu-ping;PENG Hua-rong;SONG Jian-xun;WU Qian;CHENG Guan-xun(Department of Radiology,Shenzhen Baoan People's Hospital,Shenzhen 518100,Guangdong,CHINA;Department of Radiology,Shenzhen Hospital of Peking University,Shenzhen 518306,Guangdong,CHINA)

机构地区：[1]深圳市宝安区人民医院医学影像科,广东深圳518100 [2]深圳市北京大学深圳医院医学影像科,广东深圳518306

出　　处：《海南医学》2020年第14期1853-1856,共4页Hainan Medical Journal

基　　金：广东省深圳市宝安区医疗卫生基础研究项目(编号:2019JC025)。

摘　　要：目的探讨3.0T MRI多模态MR成像技术对膝关节骨性关节炎软骨损伤的诊断价值。方法选择深圳市宝安区人民医院2018年1月至2018年12月间经关节镜检查或治疗确诊膝关节骨性关节炎软骨损伤并有完整MRI检查资料的患者共73例、213个病变部位,以关节镜检查结果作为标准,比较不同MRI成像技术对软骨损伤诊断的正确率、敏感性、特异性及Kappa值。结果常规序列中,3D-DESS-WE序列对不同级别软骨损伤的诊断正确率、Kappa值、总体诊断正确率、敏感性和特异性明显高于PDWI,差异均具有统计学意义(P<0.05);Mapping定量成像技术中,T2-star-Mapping序列对膝关节不同级别软骨损伤的诊断正确率、Kappa值、总体正确率、敏感性和特异性最高,但与T2 Mapping比较差异均无统计学意义(P>0.05),而T2 Mapping和T2-star-Mapping的上述各项指标明显优于T1 Mapping,差异均具有统计学意义(P<0.05);DESS和T2-star-Mapping技术联合应用时,膝关节软骨损伤诊断的敏感性、特异性和总体正确率均有提高,尤其是特异性提高更为明显,差异均具有统计学意义(P<0.05)。结论3D-DESS-WE和T2-star-Mapping成像技术对软骨损伤诊断价值更高,两者联合应用可明显提高膝关节骨性关节炎软骨病变的诊断。Objective To investigate the diagnostic value of multi-modal 3.0 T MR imaging for cartilage lesion in knee osteoarthritis(KOA).Methods Seventy-three patients diagnosed as knee osteoarthritis by arthroscopy or treatment(including 213 lesions)with complete MRI data in Shenzhen Baoan People’s Hospital from January 2018 to December 2018 were selected.The arthroscopic results were used as the standard to compare the accuracy,sensitivity,specificity,and Kappa values of cartilage lesions by different MR imaging techniques.Results In the conventional sequences,the diagnostic accuracy of 3D-DESS-WE sequence for different levels of cartilage injury,Kappa value,overall diagnostic accuracy,sensitivity and specificity were all significantly higher than those of PDWI(P<0.05).In mapping quantitative imaging sequences,the diagnostic accuracy of T2-star-Mapping sequence for different levels of cartilage injury,Kappa value,overall diagnostic accuracy,sensitivity and specificity were the highest,but showed no statistically significant difference with T2 Mapping(P>0.05).However,the indexes of T2 Mapping and T2-star-mapping were significantly better than T1 Mapping(P<0.05).When DESS and T2-star-mapping were used together,the sensitivity,specificity,and overall accuracy of the diagnosis of knee cartilage injury were improved,especially the specificity,with statistically significant difference(P<0.05).Conclusion 3D-DESS-WE and T2-star-mapping have higher diagnostic value for cartilage lesions in KOA,and the combined application of the two can significantly improve the diagnosis value of cartilage lesions in KOA.

关 键 词：膝关节 骨性关节炎 软骨 磁共振成像 定量成像 

分 类 号：R684.3[医药卫生—骨科学]