中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
25期
1752-1755
,共4页
赵晨%毕擎%夏冰%狄幸波%朱丹杰%郑劼%洪剑飞%邱斌松%章水均%顾海峰
趙晨%畢擎%夏冰%狄倖波%硃丹傑%鄭劼%洪劍飛%邱斌鬆%章水均%顧海峰
조신%필경%하빙%적행파%주단걸%정할%홍검비%구빈송%장수균%고해봉
磁共振成像%踝关节%软骨疾病%关节镜检查
磁共振成像%踝關節%軟骨疾病%關節鏡檢查
자공진성상%과관절%연골질병%관절경검사
Magnetic resonance imaging%Ankle joint%Cartilage diseases%Arthroscopy
目的 对照不同序列踝关节软骨病损的MRI特点与关节镜表现,评价特殊序列,即脂肪抑制三维稳态旋进快速成像FS-3D-FISP对软骨病变的诊断价值.方法 对因踝关节疼痛拟行踝关节镜检查的40例(41踝)患者,术前常规行T2加权快速自旋回波FSE-T2WI、质子密度加权快速自旋回波FSE-PDWI和FS-3D-FISP 3种MRI序列扫描,分别得到MRI分级结果,并与关节镜分级诊断结果进行比较.结果 以关节镜诊断为标准,FS-3D-FISP序列敏感度最高,可达92.9%.在敏感度上FS-3D-1 ISP>FSE-FDWI>FSE-T2WI,与关节镜诊断的一致性上:FS-3D-FISP的Kappa值达到0.7590,一致性高,也明显优于FSE-PDWI和FSE-T2WI (P<0.01).结论 FS-3D-FISP序列能够准确地反映软骨病变,并且能较真实体现早期的软骨病变,与关节镜诊断结果具有良好的一致性,而且通过三维重建对软骨病变进行立体定位诊断,能更准确地显示病变的部位及程度,并对其进行合理
分级,更好地指导临床决策.
目的 對照不同序列踝關節軟骨病損的MRI特點與關節鏡錶現,評價特殊序列,即脂肪抑製三維穩態鏇進快速成像FS-3D-FISP對軟骨病變的診斷價值.方法 對因踝關節疼痛擬行踝關節鏡檢查的40例(41踝)患者,術前常規行T2加權快速自鏇迴波FSE-T2WI、質子密度加權快速自鏇迴波FSE-PDWI和FS-3D-FISP 3種MRI序列掃描,分彆得到MRI分級結果,併與關節鏡分級診斷結果進行比較.結果 以關節鏡診斷為標準,FS-3D-FISP序列敏感度最高,可達92.9%.在敏感度上FS-3D-1 ISP>FSE-FDWI>FSE-T2WI,與關節鏡診斷的一緻性上:FS-3D-FISP的Kappa值達到0.7590,一緻性高,也明顯優于FSE-PDWI和FSE-T2WI (P<0.01).結論 FS-3D-FISP序列能夠準確地反映軟骨病變,併且能較真實體現早期的軟骨病變,與關節鏡診斷結果具有良好的一緻性,而且通過三維重建對軟骨病變進行立體定位診斷,能更準確地顯示病變的部位及程度,併對其進行閤理
分級,更好地指導臨床決策.
목적 대조불동서렬과관절연골병손적MRI특점여관절경표현,평개특수서렬,즉지방억제삼유은태선진쾌속성상FS-3D-FISP대연골병변적진단개치.방법 대인과관절동통의행과관절경검사적40례(41과)환자,술전상규행T2가권쾌속자선회파FSE-T2WI、질자밀도가권쾌속자선회파FSE-PDWI화FS-3D-FISP 3충MRI서렬소묘,분별득도MRI분급결과,병여관절경분급진단결과진행비교.결과 이관절경진단위표준,FS-3D-FISP서렬민감도최고,가체92.9%.재민감도상FS-3D-1 ISP>FSE-FDWI>FSE-T2WI,여관절경진단적일치성상:FS-3D-FISP적Kappa치체도0.7590,일치성고,야명현우우FSE-PDWI화FSE-T2WI (P<0.01).결론 FS-3D-FISP서렬능구준학지반영연골병변,병차능교진실체현조기적연골병변,여관절경진단결과구유량호적일치성,이차통과삼유중건대연골병변진행입체정위진단,능경준학지현시병변적부위급정도,병대기진행합리
분급,경호지지도림상결책.
Objective To compare several sequences of MRI and arthroscopy for detecting the ankle articular cartilage lesions and to evaluate the clinical outcome of special sequence of FS-3D-FISP.Methods Forty pailents (41 ankles) with iterative ankle pain who were scheduled for arthroseopy underwent MR scanning.including FS-3D-FISP.FSE T2WI and FSE PDWI sequences.The results of each sequence were then compared with the arthroseopic findings.Results Using arthroscopic results as the standard of reference,the FS-3D-FISP images had the higher sensitivity (92.86%) than the other two sequences.The FS-3D-FISP sequence wag well consistent with the result of arthroacopy. Kappa value (0.7590) was higher than the other two sequences (P<0.01).Conclusion As a favorable scanning sequence,FS-3D-FISP imaging can show the early-stage pathological changes of articular cartilage and it has an excellent correlation with the arthroseopic findings.A 3-D reconstruction is helpful to determine the location and the degree of lesion and obtain a more accurate classification to guide clinical decisions.
