中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2011年
18期
2459-2461
,共3页
陈树平%陈健湘%王立振%吕涵青
陳樹平%陳健湘%王立振%呂涵青
진수평%진건상%왕립진%려함청
关节软骨%磁共振成像%关节镜%成像序列%膝关节
關節軟骨%磁共振成像%關節鏡%成像序列%膝關節
관절연골%자공진성상%관절경%성상서렬%슬관절
Articularcartilage%Magnetic resonance imaging%Arthroscopy%Sequence%Knee
目的 通过比较四种磁共振(MRI)成像序列诊断膝关节软骨病变的准确性，探讨各序列的优缺点，评价诊断软骨病变的最佳序列。方法 31例36侧膝关节镜检查患者，将每侧膝关节软骨面分为5个区域。MRI成像采用快速自旋回波T1加权序列（T1WI-TSE）、脂肪抑制T2加权快速回波序列(T2WI-TSE-SPIR)、脂肪抑制质子密度快速自旋回波序列（PDW-TSE-SPIR）、扰相三维脂肪抑制梯度回波系列（3D-WATSC）四个序列。按Recht标准分级诊断180个关节软骨面，分别与膝关节镜分级诊断结果对照。MRI各序列诊断价值的真实性指标为敏感度、特异度、准确度，一致性指标用Kappa值。结果 以关节镜诊断为标准，各序列诊断软骨病变的敏感度、特异度、准确度、Kappa值分别为：T1WI-TSE序列诊63.8％、95.3％、78.8％、0.403；T2WI-TSE-SPIR序列56.3％、97.6％、76.1％、0.353；PDW-TSE-SPIR序列79.8％、93.0％、86.1％、0.642；3D-WATSC序列96.8％、88.3％、92.8％、0.812。结论 3D-WATSC序列诊断膝关节软骨病变的准确度及Kappa值均优于其它序列，与关节镜诊断结果具有一致性，是诊断膝关节软骨病变的最佳扫描序列。
目的 通過比較四種磁共振(MRI)成像序列診斷膝關節軟骨病變的準確性，探討各序列的優缺點，評價診斷軟骨病變的最佳序列。方法 31例36側膝關節鏡檢查患者，將每側膝關節軟骨麵分為5箇區域。MRI成像採用快速自鏇迴波T1加權序列（T1WI-TSE）、脂肪抑製T2加權快速迴波序列(T2WI-TSE-SPIR)、脂肪抑製質子密度快速自鏇迴波序列（PDW-TSE-SPIR）、擾相三維脂肪抑製梯度迴波繫列（3D-WATSC）四箇序列。按Recht標準分級診斷180箇關節軟骨麵，分彆與膝關節鏡分級診斷結果對照。MRI各序列診斷價值的真實性指標為敏感度、特異度、準確度，一緻性指標用Kappa值。結果 以關節鏡診斷為標準，各序列診斷軟骨病變的敏感度、特異度、準確度、Kappa值分彆為：T1WI-TSE序列診63.8％、95.3％、78.8％、0.403；T2WI-TSE-SPIR序列56.3％、97.6％、76.1％、0.353；PDW-TSE-SPIR序列79.8％、93.0％、86.1％、0.642；3D-WATSC序列96.8％、88.3％、92.8％、0.812。結論 3D-WATSC序列診斷膝關節軟骨病變的準確度及Kappa值均優于其它序列，與關節鏡診斷結果具有一緻性，是診斷膝關節軟骨病變的最佳掃描序列。
목적 통과비교사충자공진(MRI)성상서렬진단슬관절연골병변적준학성，탐토각서렬적우결점，평개진단연골병변적최가서렬。방법 31례36측슬관절경검사환자，장매측슬관절연골면분위5개구역。MRI성상채용쾌속자선회파T1가권서렬（T1WI-TSE）、지방억제T2가권쾌속회파서렬(T2WI-TSE-SPIR)、지방억제질자밀도쾌속자선회파서렬（PDW-TSE-SPIR）、우상삼유지방억제제도회파계렬（3D-WATSC）사개서렬。안Recht표준분급진단180개관절연골면，분별여슬관절경분급진단결과대조。MRI각서렬진단개치적진실성지표위민감도、특이도、준학도，일치성지표용Kappa치。결과 이관절경진단위표준，각서렬진단연골병변적민감도、특이도、준학도、Kappa치분별위：T1WI-TSE서렬진63.8％、95.3％、78.8％、0.403；T2WI-TSE-SPIR서렬56.3％、97.6％、76.1％、0.353；PDW-TSE-SPIR서렬79.8％、93.0％、86.1％、0.642；3D-WATSC서렬96.8％、88.3％、92.8％、0.812。결론 3D-WATSC서렬진단슬관절연골병변적준학도급Kappa치균우우기타서렬，여관절경진단결과구유일치성，시진단슬관절연골병변적최가소묘서렬。
Objective To compare the accuracy of the four sequences of MRI in the diagnosis of articular cartilage injury of the knee and to investigate the advantage and shortage of the four sequences. In order to evaluate the most adequate sequence in detecting articular cartilage injury of the knee. Methods 36 knee joints of 31 patients,underwent MRI scanning prior to arthroscopy included T1WI-TSE,T2 WI-TSE-SPIR, PDW-TSE-SPIR,3D-WATSC. Divided each knee side of every cartilage into five parts. Investigated and diagnosed the 180 articular cartilage surface according to Recha criteria by detecting and compared with arthroscopic examination respectively. The accurate criteria of the four sequences of MRI was sensitivity, specificity, accuracy. The criteria of correlation was the value of Kappa.Results Compared with the arthroscopic result which was the gold standard, the sensitivity, specificity, accuracy and Kappa value of the T1 W-TSE sequence was 63.8％ ,95.3％ ,78.8％ and 0. 403 respectively;The sensitivity,specificity ,accuracy and Kappa value of the T2WI-TSE-SPIR sequence was 56.3％ ,97.6％ ,76.1％ and 0. 353 respectively.The sensitivity,specificity,accuracy and Kappa value of the PDW-TSE-SPIR sequence was 79. 8％, 93.0％ ,86. 1％and 0. 642 respectively; The sensitivity, specificity, accuracy and Kappa value of the 3D-WATSC was 96. 8％,88. 3％ ,92.8％ and 0. 812 respectively. Conclusion The accuracy and Kappa values of Fat-suppressed three-dimensiunal fast spoiled gradient-echo sequence (3D-WATSC)was superior to other sequences in the diagnosis of articular cartilage injury of the knee. The correlation between 3D-WATSC and arthroscopy in detecting cartilage injury was remarkable. 3D-WATSC had been deemed the most adequate sequence in detecting articular cartilage injury of the knee.
