三维快速自旋回波序列扫描联合多层螺旋CT在膝关节交叉韧带损伤中诊断价值探究  

Diagnostic value of 3D fast spin-echo sequence scanning combined with multislice spiral CT in knee cruciate ligament injury

作　　者：李有强 王海蛟 朱步奇 王亮[3] 钱宏[4] 王长垠[5] LI You-qiang;WANG Hai-jiao;ZHU Bu-qi;WANG Liang;QIAN Hong;WANG Chang-yin(Radiology Department,Handan Hospital of Traditional Chinese Medicine,Handan056000,Hebei,China;Orthopedic Department,Handan Hospital of Traditional Chinese Medicine,Handan056000,Hebei,China;Pharmacy Department,Handan Hospital of Traditional Chinese Medicine,Handan056000,Hebei,China;Department of Osteonosus and Traumatism of TCM,Handan Hospital of Traditional Chinese Medicine,Handan 056000,Hebei,China;Encephalopathy Department,Handan Hospital of Traditional Chinese Medicine,Handan056000,Hebei,China)

机构地区：[1]邯郸市中医院放射科,河北邯郸056000 [2]邯郸市中医院骨伤科,河北邯郸056000 [3]邯郸市中医院药剂科,河北邯郸056000 [4]邯郸市中医院中医骨伤科,河北邯郸056000 [5]邯郸市中医院脑病科,河北邯郸056000

出　　处：《中国骨伤》2024年第2期153-158,共6页China Journal of Orthopaedics and Traumatology

基　　金：河北省中医药类科研计划课题(编号:2020581)。

摘　　要：目的:探索膝关节交叉韧带损伤诊断中应用三维快速自旋回波(three-dimensional fast spin echo,3D-SPACE)联合多层螺旋CT(multislice spiral CT,MSCT)潜在价值。方法:选取2020年4月至2021年4月接诊的120例膝关节交叉韧带损伤患者,男78例,女42例,年龄21~68(41.52±4.13)岁,依次采用单独MSCT扫描仪扫描、单独3D-SPACE序列扫描及3D-SPACE序列联合MSCT扫描。比较3种诊断方式对膝关节前后交叉韧带损伤分级情况,观察膝关节前后交叉韧带前内侧束及后外侧束的长度及其与水平面的夹角,判断3种诊断方式在膝关节交叉韧带损伤中的诊断价值。结果:单独3D-SPACE序列扫描与单独MSCT检测在总诊断率和分级总诊断率方面差异无统计学意义(P>0.05);3D-SPACE序列扫描联合MSCT检测总诊断率和分级总诊断率显著高于单独3D-SPACE序列扫描或MSCT检测(P<0.05);单独3D-SPACE序列扫描与单独MSCT检测对膝关节前后交叉韧带相关测量值比较,差异无统计学意义(P>0.05);3D-SPACE序列扫描联合MSCT检测对膝关节前后交叉韧带测量值明显高于单独3D-SPACE序列扫描或MSCT检测(P<0.05);3D-SPACE序列扫描联合MSCT评估受试者工作特征(receiver operating characteristic,ROC)曲线下面积为0.960,明显高于3D-SPACE序列扫描与MSCT单独评估ROC曲线下面积0.756和0.795;单独3D-SPACE序列扫描与3D-SPACE序列扫描联合MSCT分析预测模型差异有统计学意义(Z=2.236,P<0.05),单独MSCT与3D-SPACE序列扫描联合MSCT分析预测模型差异有统计学意义(Z=2.653,P<0.05)。结论:对膝关节交叉韧带损伤应用3D-SPACE序列联合MSCT扫描,可以提升临床膝关节交叉韧带损伤患者的诊断率,可以作为膝关节交叉韧带损伤患者的诊断工具。Objective To explore the potential value of three-dimensional fast spin echo(3D-SPACE)combined with multilayer spiral CT(MSCT)in the diagnosis of knee cruciate ligament injury,to provide a new direction for the optimization of subsequent clinical diagnosis.Methods A total of 120 patients with knee cruciate ligament injury were treated from April 2020 to April 2021,aged from 21 to 68 with an average of(41.52±4.13)years old.For all patients,separate MSCT scanner scans,3D-SPACE sequence scans alone and 3D-SPACE sequence combined with MSCT scans were used.The injury and classification of the anterior and posterior cruciate ligament of the knee were compared,the length of the anterior-medial bundle and posterolateral bundle and its angle of the knee with the horizontal plane were observed,the diagnostic value of 3 diagnostic methods in knee cruciate ligament injury were determined.Results There was no significant difference between the 3D-SPACE sequence scan alone and the MSCT test alone on the total diagnostic rate and grading total diagnostic rate(P>0.05).The total diagnostic rate and grading total diagnostic rate of 3D-SPACE scan combined with MSCT were significantly higher than those of 3D-SPACE scan or MSCT alone(P<0.05).The 3D-SPACE sequence scan alone and the MSCT detection alone had no significant difference in the measurement values related to the anterior and posterior cruciate ligaments of the knee joint(P>0.05).3D-SPACE sequence scanning combined with MSCT detection on the knee joint anterior and posterior cruciate ligament related measurements were significantly higher than the 3D-SPACE sequence scan or MSCT detection alone(P<0.05).The area under the ROC curve estimated by 3D-SPACE sequence scanning combined with MSCT was 0.960,which was significantly higher than that of 3D-SPACE sequence scanning and MSCT alone evaluating the area under the ROC curve line of 0.756 and 0.795.The combined 3D-SPACE sequence scanning and 3D-SPACE sequence scanning MSCT analysis and prediction models were statistically diffe

关 键 词：三维快速自旋回波 多层螺旋CT 膝关节 交叉韧带 韧带损伤 诊断价值 

分 类 号：R604[医药卫生—外科学]