MRI同时多层成像-质子密度加权成像序列在膝关节半月板撕裂中的应用价值  

Application of MRI based on simultaneous multi-slice proton density weighted imaging sequence in knee meniscus tear

作　　者：何朝梁 杨洁 刘玉建[1] 赵志强[1] 李艳[1] 唐翎[1] 黄燕涛[1] 仲建全[1] HE Chaoliang;YANG Jie;LIU Yujian;ZHAO Zhiqiang;LI Yan;TANG Ling;HUANG Yantao;ZHONG Jianquan(CT Room of Radiology Department,Zigong First People’s Hospital,Zigong 643000,China)

机构地区：[1]自贡市第一人民医院放射科CT室,四川自贡643000

出　　处：《中国中西医结合影像学杂志》2025年第2期244-248,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：2023年自贡市公立医院改革与高质量发展示范项目(ZG-KY-2023-008)。

摘　　要：目的:探讨MRI同时多层成像-质子密度加权成像(SMS-PDWI)序列在膝关节半月板撕裂中的应用价值。方法:回顾性选择40例膝关节半月板损伤患者,均行MRI膝关节扫描,包括并行采集技术-质子密度加权成像(iPAT-PDWI)(3 mm)加速、SMS-PDWI(3 mm)与SMS-PDWI(1.5 mm)加速矢状位序列,同时行关节镜检查。由2位影像医师独立阅片,测量iPAT-PDWI(3 mm)与SMS-PDWI(3 mm)图像上肌肉与半月板信号强度、标准差,计算半月板SNR和CNR,对图像进行主观评分,并单独评估每个序列半月板损伤程度;以关节镜诊断为标准,计算各序列诊断半月板撕裂的敏感度、特异度和准确率。比较各序列图像的主观评分、SNR、CNR和半月板撕裂诊断差异。结果:2位医师对iPAT-PDWI(3 mm)、SMS-PDWI(3 mm)、SMS-PDWI(1.5 mm)序列图像的主观评分差异均无统计学意义(均P>0.05)。iPAT-PDWI(3 mm)和SMS-PDWI(3 mm)图像半月板的SNR和CNR差异均无统计学意义(均P>0.05)。SMS-PDWI(3 mm)和iPAT-PDWI(3 mm)序列评估半月板撕裂的敏感度、特异度和准确率差异均无统计学意义(均P>0.05);SMS-PDWI(1.5 mm)序列评估半月板撕裂的敏感度和准确率均高于SMS-PDWI(3 mm)和iPAT-PDWI(3 mm)序列,差异均有统计学意义(均P<0.05)。结论:SMS-PDWI扫描膝关节可在不增加扫描时间的同时采集更多层数更薄图像,提高半月板撕裂诊断准确率,具有较高的临床应用价值。Objective:To evaluate the application value of simultaneous multi-slice proton density weighted imaging(SMS-PDWI)in knee meniscus tear.Methods:This retrospective study analyzed 40 patients with arthroscopically confirmed meniscal injuries.All patients underwent MRI with three sagittal sequences,iPAT-PDWI(thickness of 3 mm),SMS-PDWI(3 mm)and SMS-PDWI(1.5 mm).The signal intensity and standard deviation of muscle and meniscus were measured on iPAT-PDWI(3 mm)and SMS-PDWI(3 mm)images,and SNR and CNR of meniscus were calculated.Two radiologists assessed the images subjective score and meniscus injury degree of each sequence.With the arthroscopy results as the diagnostic standard,the sensitivity,specificity and accuracy of each sequence in the diagnosis of meniscus tear were calculated.The differences of subjective score,SNR,CNR and meniscus tear were compared.Results:The subjective scores of three sequences images had no significant differences(P>0.05).There were no significant differences in SNRs or CNRs of meniscus between iPAT-PDWI(3 mm)and SMS-PDWI(3 mm)(all P>0.05).SMS-PDWI(3 mm)and iPAT-PDWI(3 mm)had no statistical differences in the sensitivity,specificity or accuracy in the diagnosis of meniscus tear(all P>0.05).The sensitivity and accuracy of SMS-PDWI(1.5 mm)were higher than those of SMS-PDWI(3 mm)and iPAT-PDWI(3 mm)in evaluating meniscus tear(all P<0.05).Conclusions:SMS-PDWI scan of knee joint can improve the accuracy of the diagnosis and evaluation of meniscus tear,which has a high clinical application value.

关 键 词：磁共振成像 膝关节 同时多层成像技术 质子密度加权成像 半月板 

分 类 号：R68[医药卫生—骨科学]