磁共振3D-WATS对膝关节软骨损伤的诊断价值研究  

Study on the diagnostic value of magnetic resonance 3D-WATS for knee cartilage injuries

作　　者：彭龙辉 吴贵成 杨志杰 蔡立杰 蔡素娇 PENG Longhui;WU Guicheng;YANG Zhijie;CAI Lijie;CAI Sujiao(The 95th Hospital of Putian,Putian,Fujian 351100,China)

机构地区：[1]莆田九十五医院,福建莆田351100

出　　处：《现代医药卫生》2024年第24期4202-4205,共4页Journal of Modern Medicine & Health

摘　　要：目的探讨磁共振三维选择性水激发序列(3D-WATS)对膝关节软骨损伤的诊断价值。方法选择2022年1月至2023年9月该院诊治的疑似膝关节软骨损伤患者76例。所有入选者均进行磁共振成像(MRI)检查。以膝关节镜检查结果作为“金标准”,分析不同序列[T2弛豫时间图成像(T2-mapping)、质子密度加权成像(PDWI)、3D-WATS]诊断膝关节软骨损伤的临床价值,并计算不同序列检查结果与“金标准”检查结果的一致性。另外对比不同序列检查软骨非缺损处与缺损处信号强度比值。结果76例疑似膝关节软骨损伤患者中有52例确诊。3D-WATS诊断膝关节软骨损伤的灵敏度、特异度、准确度、阳性预测值、阴性预测值[96.15%(50/52)、95.83%(23/24)、96.05%(73/76)、98.04%(50/51)、92.00%(23/25)]均高于PDWI、T2-mapping检查[分别为73.08%(38/52)、58.33%(14/24)、68.42%(52/76)、79.17%(38/48)、50.00%(14/28)及80.77%(42/52)、66.67%(16/24)、76.32%(58/76)、84.00%(42/50)、61.54%(16/26)],差异均有统计学意义(P<0.05)。PDWI序列诊断膝关节软骨损伤的结果与“金标准”结果一致性较差(Kappa=0.301,P<0.05),T2-mapping序列诊断膝关节软骨损伤的结果与“金标准”结果一致性理想(Kappa=0.464,P<0.05),3D-WATS诊断膝关节软骨损伤的结果与“金标准”结果一致性极好(Kappa=0.910,P<0.05)。3D-WATS、PDWI、T2-mapping检查软骨非缺损处与缺损处信号强度比值分别为(1.79±0.43)、(1.31±0.38)、(1.04±0.27),各序列间对比差异有统计学意义(P<0.05)。结论膝关节软骨损伤诊断中应用磁共振3D-WATS具有较高的准确度、灵敏度,可为临床诊断提供更多有价值的参考信息,值得推广应用。Objective To explore the diagnostic value of magnetic resonance three-dimensional water excitation with spatial targeting(3D-WATS)for knee cartilage injuries.Methods A total of 76 patients with suspected knee cartilage injuries diagnosed and treated in our hospital from January 2022 to September 2023 were selected.All participants underwent magnetic resonance imaging(MRI).With arthroscopic examination of the knee joint as the“gold standard,”the clinical value of different sequences[T2 relaxation time mapping(T2-mapping),proton density-weighted imaging(PDWI),and 3D-WATS]in diagnosing knee cartilage injuries was analyzed,and the consistency between the results of different sequences and the“gold standard”was calculated.Additionally,the signal intensity ratios of non-defective and defective cartilage areas in different sequences were compared.Results Among the 76 patients with suspected knee cartilage injuries,52 were confirmed.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of 3D-WATS in diagnosing knee cartilage injuries[96.15%(50/52),95.83%(23/24),96.05%(73/76),98.04%(50/51),92.00%(23/25)]were higher than those of PDWI and T2-mapping[73.08%(38/52),58.33%(14/24),68.42%(52/76),79.17%(38/48),50.00%(14/28)and 80.77%(42/52),66.67%(16/24),76.32%(58/76),84.00%(42/50),61.54%(16/26),respectively],with statistically significant differences(P<0.05).The diagnostic results of PDWI for knee cartilage injuries showed poor consistency with the“gold standard”(Kappa=0.301,P<0.05).The diagnostic results of T2-mapping for knee cartilage injuries showed good consistency with the“gold standard”(Kappa=0.464,P<0.05).The diagnostic results of 3D-WATS for knee cartilage injuries showed excellent consistency with the“gold standard”(Kappa=0.910,P<0.05).The signal intensity ratios of non-defective and defective cartilage areas in 3D-WATS,PDWI,and T2-mapping were 1.79±0.43,1.31±0.38,and 1.04±0.27,respectively,with statistically significant differences among the sequences(P<0.

关 键 词：膝关节软骨损伤 磁共振三维选择性水激发序列 诊断效能 

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