MR 3D-SPACE及2D-FSE技术在膝关节半月板损伤中的诊断效能  

Diagnostic efficacy of MR 3D-SPACE and 2D-FSE techniques in knee meniscus injury

作　　者：刘刚 李鹏 邬玉芹 黄巍 LIU Gang;LI Peng;WU Yuqin;HUANG Wei(Department of Radiology,the First Hospital of Changsha,Changsha 410005,China)

机构地区：[1]长沙市第一医院放射科,湖南长沙410005

出　　处：《实用放射学杂志》2025年第1期89-92,共4页Journal of Practical Radiology

基　　金：湖南省科技创新计划项目(2021SK53105)。

摘　　要：目的探讨MR三维可变反转角快速自旋回波(3D-SPACE)及二维快速自旋回波(2D-FSE)技术在膝关节半月板损伤中的诊断效能。方法收集因膝关节疼痛、外伤拟行膝关节镜检查的100例患者的影像资料,均进行关节镜检查、常规2D-FSE序列及3D-SPACE序列检查。将关节镜检查结果作为金标准,观察2种MR序列的半月板损伤分级、Ⅲ级损伤形态的分级,统计其诊断半月板损伤的诊断效能,对比其半月板组织对比噪声比(CNR)。结果经关节镜检查发现,100例疑似膝关节半月板损伤的患者中,92例半月板损伤,58例Ⅲ级半月板损伤。3D-SPACE序列分级诊断准确性(95.65%)显著优于2D-FSE序列分级诊断准确性(80.43%)(P<0.05),其中3D-SPACE序列Ⅱ级诊断准确性(96.15%)和Ⅲ级诊断准确性(94.83%)显著高于2D-FSE序列Ⅱ级(76.92%)和Ⅲ级(81.03%)(P<0.05)。3D-SPACE序列混合型撕裂诊断准确性(94.74%)显著优于2D-FSE序列(63.16%)(P<0.05)。经一致性分析证实,2D-FSE序列和3D-SPACE序列对半月板损伤总体检出的敏感度、特异度、阳性预测值、阴性预测值、准确性分别为78.26%、75.00%、97.30%、23.08%、78.00%(Kappa值=0.262)和94.57%、87.50%、98.86%、58.33%、94.00%(Kappa值=0.646)(P<0.05)。3D-SPACE序列半月板/韧带CNR高于2D-FSE序列(P<0.05)。结论3D-SPACE序列在膝关节半月板损伤的诊断中具有较高的敏感度和准确性,且在明确半月板损伤分级及部分撕裂术前定位上有着显著优势,可为疑似膝关节半月板损伤患者诊治提供更为可靠的依据。Objective To explore the diagnostic efficacy of MR with three-dimensional sampling perfection with application optimized contrast using different flip angle evolutions(3D-SPACE)and two-dimensional fast spin echo(2D-FSE)techniques in knee meniscus injury.Methods The imaging data of 100 patients who underwent arthroscopy for knee pain or trauma were collected.All patients underwent arthroscopy,conventional 2D-FSE sequence and 3D-SPACE sequence examination.Using the results of arthroscopy as the gold standard,the classification of meniscus injury and the classification of gradeⅢinjury morphology were observed in two MR sequences.The diagnostic efficacy of meniscus injury was measured,and the contrast-to-noise ratio(CNR)of meniscus tissue was compared.Results Arthroscopy revealed 92 meniscus injury,and 58 gradeⅢmeniscus injury,among 100 patients with suspected knee meniscus injury.The accuracy of classification diagnosis with the 3D-SPACE sequence(95.65%)was significantly better than that of the 2D-FSE sequence classification diagnosis acuracy(80.43%)(P<0.05).Specifically,the diagnostic accuracy of gradeⅡ(96.15%)and gradeⅢ(94.83%)with the 3D-SPACE sequence was significantly higher than that of the 2D-FSE sequence(76.92%for gradeⅡand 81.03%for gradeⅢ)(P<0.05).The diagnostic accuracy of mixed-type tears with the 3D-SPACE sequence(94.74%)was significantly better than that of the 2D-FSE sequence(63.16%)(P<0.05).Consistency analysis confirmed that the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of the 2D-FSE and 3D-SPACE sequences for overall detection of meniscus injury were 78.26%,75.00%,97.30%,23.08%and 78.00%(Kappa value=0.262)and 94.57%,87.50%,98.86%,58.33%,94.00%(Kappa value=0.646)(P<0.05),respectively.The meniscus/ligament CNR of the 3D-SPACE sequence was higher than that of the 2D-FSE sequence(P<0.05).Conclusion The 3D-SPACE sequence exhibits high sensitivity and accuracy in the diagnosis of knee meniscus injury.It has significant advantages in determining t

关 键 词：膝关节半月板损伤 三维可变反转角快速自旋回波 二维快速自旋回波 关节镜 

分 类 号：R684[医药卫生—骨科学] R445.2[医药卫生—外科学]