UTE与T2^(*) mapping成像技术定量评估肩袖撕裂的对照研究  

A comparative study of UTE and T2^(*) mapping imaging technology in quantitative assessment of rotator cuff tear

作　　者：曹馨月 卫建国 陈凯 陈振涛 汪波 刘放[1] 陈杰[1] 徐左旭 黄丙仓[1] CAO Xinyue;WEI Jianguo;CHEN Kai;CHEN Zhentao;WANG Bo;LIU Fang;CHEN Jie;XU Zuoxu;HUANG Bingcang(Department of Imaging,Shanghai PuDong GongLi Hospital,Shanghai 200135,China;Canon Medical System(China)Ltd.,Beijing 100020,China)

机构地区：[1]上海市浦东新区公利医院影像科,上海200135 [2]佳能医疗系统(中国)有限公司,北京100020

出　　处：《磁共振成像》2021年第12期84-88,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：上海市浦东新区卫生系统领先人才培养计划(编号:PWRl2017-04);浦东新区卫生系统重点学科建设(编号:PWZxk2017-26);浦东新区卫生和健康委员会学科建设(编号:PWGw2020-01)。

摘　　要：目的探讨超短回波时间(ultrashort-echo-time,UTE)与T2^(*) mapping成像技术定量评估肩袖撕裂的能力。材料与方法回顾性分析39例肩袖损伤患者,行UTE与T2^(*) mapping序列扫描。将冈上肌腱分三个亚区,以三角肌的R值(T2^(*)值的倒数)作为参考,获得每个亚区R相对值。由两名放射科医生对肩袖影像分别进行不同Zlatkin分型,共分为三型,其中Ⅰ型定义为肌腱炎,Ⅱ型定义为微小撕裂;Ⅲ型定义为大撕裂。将肌腱分为连续组(Ⅰ型)与撕裂组(Ⅱ型和Ⅲ型)。不同观察者间采用Kappa一致性检验,两种序列Zlatkin分级的比较采用Kruskal-Wallis H检验,组间采用LSD两两多重比较,两种技术的诊断效能采用ROC曲线比较。结果两名观察者间几乎完全一致(Kappa=0.821)。在UTE序列,外侧亚区与中间亚区的Ⅰ型与Ⅲ型及Ⅱ型与Ⅲ型差异有统计学意义(P<0.05);T2^(*) mapping仅Ⅱ型与Ⅲ型差异有统计学意义(P<0.05)。用UTE序列测量中间亚区判断肌腱是否撕裂的阈值为3.0755,AUC为0.782,其敏感度为0.750,特异度为0.645,其余差异无统计学意义(P>0.05)。结论 UTE技术有助于判断肩袖撕裂情况,并在中间亚区定量区分肩袖撕裂具有较好的诊断效能,为临床工作提供一种新的思路。Objective:To explore the ability of ultra-short echo time(UTE) and T2^(*) mapping imaging technology to quantitatively assess rotator cuff tears.Materials and Methods:Thirty-nine patients with rotator cuff injury were collected and underwent UTE and T2^(*) mapping sequence scan.The supraspinatus tendon was divided into three sub-regions,and the R value of the deltoid muscle(the reciprocal of the T2^(*)value) was used as a reference to obtain the relative R value of each sub-region.Two radiologists performed the Zlatkin type in different sub-regions on the rotator cuff images,which were divided into three types.Type Ⅰ was defined as tendinitis;Type Ⅱ was defined as a small tear;Type Ⅲ was defined as a large tear.Tendons were divided into continuous group(type Ⅰ) and tear group(type Ⅱ and type Ⅲ).The Kappa consistency test was used between different observers,the Kruskal-Wallis H test was used to compare the Zlatkin classification of the two sequences,the LSD pairwise multiple comparisons were used between the groups,and the diagnostic efficacy of the two techniques was compared by the receiver operating characteristic(ROC) curve.Results:There is almost complete agreement between the two observers(Kappa=0.821).In the UTE sequence,there are statistical differences between type Ⅰand type Ⅲ,type Ⅱ and type Ⅲ in the outer and middle subregions(P<0.05);T2^(*) mapping is only statistically different between type Ⅱand type Ⅲ(P<0.05)).Using UTE sequence to measure the middle subregion to judge whether the tendon is torn is 3.0755,the AUC is 0.782,the sensitivity is 0.75,the specificity is 0.645,the other subregions are not statistically significant(P>0.05),all none of the sub-regions of the T2^(*) mapping sequence is statistically significant(P>0.05).Conclusions:UTE technology is helpful to judge the rotator cuff tear and quantitatively distinguish the rotator cuff tear in the middle sub-regions.It has good diagnostic efficiency,guides further clinical treatment,and provides a new idea for clinical

关 键 词：超短回波时间 T2^(*)mapping 肩袖撕裂 定量评估 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R686[医药卫生—诊断学]