磁共振弥散加权成像多序列图像及定量参数对髌骨软化症的诊断价值  

Analysis of Diagnostic Value of Multiple Sequence Images and Quantitative Parameters of Diffusion-weighted Magnetic Resonance Imaging in Chondromalacia Patellae

作　　者：张佳乐 赵朋 王勇[1] 李少连[1] ZHANG Jiale;ZHAO Peng;WANG Yong;LI Shaolian(Department of Imaging,the Fourth People's Hospital of Hengshui City,Hengshui,Hebei 053000,China)

机构地区：[1]衡水市第四人民医院影像科,河北衡水053000

出　　处：《临床误诊误治》2023年第12期116-120,共5页Clinical Misdiagnosis & Mistherapy

基　　金：衡水市科技计划项目(2020014014Z)。

摘　　要：目的探讨磁共振弥散加权成像多序列图像及定量参数对髌骨软化症的诊断价值。方法选取2020年1月—2022年1月收治的髌骨软化症120例,均经关节镜检查确诊。所有患者行磁共振弥散加权成像多序列检查,分析三维翻转稳态自由进动(3D-DWPSIF)、磁共振扩散加权成像-平衡稳态自由进动(DW-bSSFP)、磁共振扩散加权成像-平面回波成像(DW-EPI)序列与关节镜诊断的一致性,比较不同分级患者表观弥散系数(ADC)、信噪比(SNR)、对比噪声比(CNR),分析DW-bSSFP序列ADC、SNR、CNR与髌骨软化症分级的相关性。结果DW-bSSFP序列诊断髌骨软化症分级与关节镜检查结果的一致性最高(P<0.01)。Ⅰ~Ⅱ级髌骨软化症患者3D-DWPSIF、DW-EPI序列检测ADC低于Ⅲ~Ⅳ级,DW-bSSFP序列检测ADCⅠ级<Ⅱ级<Ⅲ级<Ⅳ级(P<0.05)。不同分级髌骨软化症患者DW-bSSFP序列检测SNR高于3D-DWPSIF序列、DW-EPI序列(P<0.01);Ⅰ级髌骨软化症患者3D-DWPSIF序列、DW-EPI序列检测SNR低于Ⅱ、Ⅲ、Ⅳ级,Ⅱ、Ⅲ级低于Ⅳ级,DW-bSSFP序列检测SNRⅠ级<Ⅱ级<Ⅲ级<Ⅳ级(P<0.05)。不同分级髌骨软化症患者DW-bSSFP序列检测CNR高于3D-DWPSIF序列、DW-EPI序列(P<0.01);Ⅰ级髌骨软化症患者3D-DWPSIF序列、DW-EPI序列检测CNR高于Ⅱ、Ⅲ、Ⅳ级,Ⅱ、Ⅲ级高于Ⅳ级,DW-bSSFP序列检测CNRⅠ级>Ⅱ级>Ⅲ级>Ⅳ级(P<0.05)。结论磁共振弥散加权成像3D-DWPSIF序列、DW-EPI序列、DW-bSSFP序列均对髌骨软化症具有一定诊断价值,尤其DW-bSSFP序列与关节镜诊断结果一致性最高。Objective To evaluate the diagnostic value of multiple sequence images and quantitative parameters of diffusion-weighted magnetic resonance imaging(MRI)for chondromalacia patellae(CMP).Methods A total of 120 patients with CMP treated from January 2020 to January 2022 were selected,all of whom were confirmed by arthroscopy.All patients underwent multiple sequence examinations of diffusion-weighted MRI,and the consistency of DWI sequences with arthroscopic diagnosis was analyzed for three-dimensional inversion steady-state free preception(3D-DWPSIF),magnetic resonance diffusion-weighted image-balanced steady-state free precession(DW-bSSFP),and magnetic resonance diffusion-weighted image-plane echo imaging(DW-EPI).The apparent diffusion coefficient(ADC),signal-to-noise ratio(SNR)and contrast noise ratio(CNR)of patients with different grades were compared,and the correlation between ADC,SNR and CNR of DW-bSSFP sequence and the grade of CMP was analyzed.Results DW-bSSFP sequence in the diagnosis of CMP had the highest consistency with the results of arthroscopy(P<0.01).The ADC of 3D-DWPSIF and DW-EPI sequences in patients with grade Ⅰ to Ⅱ CMP was lower than that of grade Ⅲ to Ⅳ,and those of DW-bSSFP sequences were the lowest in patients with gradeⅠCMP,followed by those with grade Ⅱ,those with grade Ⅲ and those with grade Ⅳ CMP(P<0.05).The SNR of DW-bSSFP sequence was higher than that of 3D-DWPSIF sequence and DW-EPI sequence in patients with CMP of different grades(P<0.01).In patients with grade Ⅰ CMP,the SNR detected by 3D-DWPSIF sequence and DW-EPI sequence was lower than that of grade Ⅱ,Ⅲ and Ⅳ,and SNR of grade Ⅱ and Ⅲ was lower than that of grade Ⅳ;SNR detected by DW-bSSFP sequence was the lowest in patients with grade Ⅰ CMP,followed by those with grade Ⅱ,those with grade Ⅲ and those with grade Ⅳ CMP(P<0.05).The CNR of DW-bSSFP sequence was higher than that of 3D-DWPSIF sequence and DW-EPI sequence in patients with CMP of different grades(P<0.01).In grade Ⅰ CMP patients,the

关 键 词：髌骨软化症 弥散磁共振成像 三维翻转稳态自由进动 平衡稳态自由进动 平面回波成像 表观弥散系数 信噪比 对比噪声比 

分 类 号：R684[医药卫生—骨科学]