扩散张量成像在前交叉韧带损伤中的诊断价值  

Diagnostic Value of Diffusion Tensor Imaging in Anterior Cruciate Ligament Injury

作　　者：李培[1] 李金平 杨荣丽 付升旗[1] LI Pei;LI Jinping;YANG Rongli(Department of Radiology,Third Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan Province 453003,P.R.China)

机构地区：[1]新乡医学院第三附属医院放射科,453003 [2]新乡医学院解剖学教研室,453003

出　　处：《临床放射学杂志》2021年第1期115-120,共6页Journal of Clinical Radiology

摘　　要：目的探讨扩散张量成像(DTI)在前交叉韧带损伤程度分级诊断中的应用价值。方法搜集膝关节DTI扫描的检查正常者100例和单侧前交叉韧带撕裂伤患者100例,按照损伤程度分为Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级,在工作站划分前交叉韧带损伤组及正常组相应部位的感兴趣区(ROI),测量ROI的各向异性分数(FA)值和表观扩散系数(ADC)值,同时生成纤维束示踪成像(DTT)图像。比较前交叉韧带损伤组与正常组和不同损伤程度的FA值、ADC值,以及DTI诊断前交叉韧带损伤程度分级的诊断准确率。结果前交叉韧带损伤组与正常组相应部位的FA值和ADC值差异有统计学意义(P<0.05),前交叉韧带损伤组的FA值低于正常组,ADC值则高于正常组。前交叉韧带Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级损伤组的FA值和ADC值差异有统计学意义(P<0.05),FA值随着损伤程度增高而逐渐降低,与损伤程度呈负相关,ADC值则逐渐增高,与损伤程度呈正相关;其中组间比较的Ⅰ级与Ⅱ级的FA值和ADC值差异无统计学意义(P>0.05),其他损伤程度分级之间的FA值和ADC值差异均有统计学意义(P<0.05)。DTI、DTT、MRI诊断前交叉韧带损伤程度分级的灵敏度、特异度、准确度、阳性预测值、阴性预测值差异均有统计学意义(P<0.05),从高到低均依次为DTT、DTI、MRI。结论 DTI的FA值、ADC值与前交叉韧带的损伤程度密切相关,DTT可以直观显示前交叉韧带损伤处的三维形态,为前交叉韧带损伤程度分级提供了准确的影像诊断依据。Objective To investigate the application value of diffusion tensor imaging for the diagnostic grading of the different degrees of anterior cruciate ligamentinjury. Methods A total of 100 patients with normal knee DTI scan and 100 patients with unilateral anterior cruciate ligament laceration were collected. According to the degree of injury, they were divided into grade I, grade II, grade III, and grade IV. At the workstation, the regions of interest of the anterior cruciate ligament injury and the corresponding position of the normal group were divided, the tractography images were generated and the fractional anisotropy(FA) values and apparent diffusion coefficient(ADC) values of the regions of interest were measured.The FA values and ADC values were compared between anterior cruciate ligament injury and normal group, and among the different degrees ofinjury, the diagnostic rate of diffusion tensorimaging in the different degrees of anterior cruciate ligament injury. Results The FA value and ADC value of the corresponding parts of the ACL injury group and the normal group were significantly different(P<0.05). The FA value of the ACL injury group was lower than that of the normal group, and the ADC value was higher than that of the normal group. The FA value and ADC value of the anterior cruciate ligament grade Ⅰ, Ⅱ, Ⅲ, and Ⅳ injury groups were significantly different(P<0.05). The FA value gradually decreased with the increase of the degree of injury, and was negatively correlated with the degree of injury, ADC value gradually increased and was positively correlated with the degree of injury;the difference between the FA values and ADC values of grade I and grade II between the groups was not statistically significant(P>0.05), and the FA values and the values of other grades of injury. The difference in ADC values was statistically significant(P<0.05). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of DTI, DTT, and MRI in the diagnosis of anterior cruciat

关 键 词：扩散张量成像 前交叉韧带损伤 纤维束示踪成像 前交叉韧带 磁共振成像 

分 类 号：R686.5[医药卫生—骨科学]