MR延迟增强扫描在膝关节软骨损伤早期的临床诊断价值  

Clinical Application Value of Delayed Enhanced MRI Scanning in Early Cartilage Injury of Knee Joint

作　　者：冼新源[1] 林益良[1] 方培[1] 张中文[1] 黄发明[1] 盛国全[1] 林琼梅 Xian Xinyuan;Lin Yiliang;Fang Pei;Zhang Zhongwen;Huang Faming;Sheng Guoquan;Lin Qiongmei(Guigang Orthopedic Hospital of Integrated Traditional and Western Medicine,Guangxi 537100)

机构地区：[1]贵港市中西医结合骨科医院,广西537100

出　　处：《现代医用影像学》2023年第11期2080-2084,共5页Modern Medical Imageology

基　　金：贵港市科学研究与技术开发计划项目(编号:贵科攻1701044)。

摘　　要：目的:探讨MR延迟增强扫描在膝关节软骨损伤早期的临床诊断价值。方法:选取我院58例临床诊断为膝关节损伤患者行常规MR平扫及增强,完成常规序列MR平扫后,行静脉注射钆喷酸葡胺(Gd-DTPA),注药后嘱患者做平地运动,30分钟后行MR延迟增强扫描,采用三维脂肪抑制快速扰相梯度回波(3D-FS-FLASH)序列完成扫描,对常规MR平扫、延迟MR增强扫描所得图像进行分析,确定有无软骨损伤及软骨损伤的部位、范围等。记录常规MR平扫与延迟增强序列下膝关节6处关节软骨损伤的分级,然后以关节镜为金标准,计算常规MR平扫与MR延迟增强扫描的准确度、敏感度和特异度,再进行统计学分析。结果:两种磁共振检查方法在诊断膝关节软骨总体准确度及Ⅰ、Ⅱ级损伤的准确度差别具有统计学意义(P<0.01)。结论:MR延迟增强检查诊断软骨损伤的敏感度最高,常规MR平扫的特异度最高。MR延迟增强扫描是目前诊断膝关节软骨损伤早期的最优方法,值得推广应用。Objective:To explore the clinical diagnostic value of delayed contrast-enhanced MR imaging in the early stage of knee joint cartilage injury.Methods:58 patients diagnosed with knee joint injury in our hospital were selected for routine MR plain scan and enhancement.After completing the routine sequence MR plain scan,intravenous injection of gadolinium pentoxide meglumine(Gd DTPA)was performed.After the injection,the patients were instructed to exercise on the ground,and 30 minutes later,delayed enhanced MR scanning was performed.The scanning was completed using three-dimensional fat suppression fast disturbance gradient echo(3D-FS-FLASH)sequence.The images obtained from routine MR plain scan and delayed enhanced MR scanning were analyzed,Determine whether there is cartilage damage and the location and extent of cartilage damage.Record the grading of cartilage damage at 6 locations of the knee joint under routine MR plain scan and delayed enhancement sequence,and then use arthroscopy as the gold standard to calculate the accuracy,sensitivity,and specificity of routine MR plain scan and MR delayed enhancement scan,and then conduct statistical analysis.Results:There was a statistically significant difference between the two magnetic resonance imaging methods in the overall accuracy of diagnosing knee joint cartilage and the accuracy of grade I and II injuries(P<0.01).Conclusion:Delayed contrast-enhanced MR examination has the highest sensitivity in diagnosing cartilage injury,and conventional MR plain scan has the highest specificity.MR delayed contrast-enhanced scanning is currently the optimal method for early diagnosis of knee joint cartilage injury,and is worthy of promotion and application.

关 键 词：磁共振成像 延迟增强 软骨损伤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R684[医药卫生—诊断学]