中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2015年
7期
528-532
,共5页
肇刚%刘玉杰%曲峰%袁邦拓%王江涛%申学振%李宏亮%陆兮%郭旗
肇剛%劉玉傑%麯峰%袁邦拓%王江濤%申學振%李宏亮%陸兮%郭旂
조강%류옥걸%곡봉%원방탁%왕강도%신학진%리굉량%륙혜%곽기
骨关节炎,膝%关节成形术,置换,膝%关节镜检查
骨關節炎,膝%關節成形術,置換,膝%關節鏡檢查
골관절염,슬%관절성형술,치환,슬%관절경검사
Osteoarthritis,knee%Arthroplasty,replacement,knee%Arthroscopy
目的 分析三维脂肪抑制快速扰相梯度回波(3D-FS-SPGR)序列诊断膝关节软骨损伤、分级的效力.方法 选取2013年6月至2014年5月在解放军总医院骨科诊断为膝骨关节炎患者56例,男性26例,女性30例;年龄52 ～73岁,平均年龄61.8岁.患者均行膝关节MRI检查,加扫描3D-FS-SPGR序列,以术中行关节镜探查为金标准的诊断效力,评价3D-FS-SPGR与T2WI序列对软骨损伤与关节镜下检查结果相符合的准确率.结果 56个膝关节按照不同区域分为336个软骨关节面.正常关节面占55.1％;表现为早期骨关节炎者为21.4％;中晚期骨关节炎比率为23.5％.3 D-FS-SPGR序列对软骨损伤分级诊断与关节镜下诊断相比一致率为90.2％.3D-FS-SPGR序列显示膝关节软骨病变的灵敏度为93.1％,特异度为98.3％,Kappa值为0.849.T2WI序列显示膝关节软骨病变的灵敏度为84.4％,特异度为96.9％,Kappa值为0.671.结论 3D-FS-SPGR序列MRI对软骨损伤的评价具有较高的灵敏度和特异度,对软骨损伤分级亦具有较高的一致性.
目的 分析三維脂肪抑製快速擾相梯度迴波(3D-FS-SPGR)序列診斷膝關節軟骨損傷、分級的效力.方法 選取2013年6月至2014年5月在解放軍總醫院骨科診斷為膝骨關節炎患者56例,男性26例,女性30例;年齡52 ～73歲,平均年齡61.8歲.患者均行膝關節MRI檢查,加掃描3D-FS-SPGR序列,以術中行關節鏡探查為金標準的診斷效力,評價3D-FS-SPGR與T2WI序列對軟骨損傷與關節鏡下檢查結果相符閤的準確率.結果 56箇膝關節按照不同區域分為336箇軟骨關節麵.正常關節麵佔55.1％;錶現為早期骨關節炎者為21.4％;中晚期骨關節炎比率為23.5％.3 D-FS-SPGR序列對軟骨損傷分級診斷與關節鏡下診斷相比一緻率為90.2％.3D-FS-SPGR序列顯示膝關節軟骨病變的靈敏度為93.1％,特異度為98.3％,Kappa值為0.849.T2WI序列顯示膝關節軟骨病變的靈敏度為84.4％,特異度為96.9％,Kappa值為0.671.結論 3D-FS-SPGR序列MRI對軟骨損傷的評價具有較高的靈敏度和特異度,對軟骨損傷分級亦具有較高的一緻性.
목적 분석삼유지방억제쾌속우상제도회파(3D-FS-SPGR)서렬진단슬관절연골손상、분급적효력.방법 선취2013년6월지2014년5월재해방군총의원골과진단위슬골관절염환자56례,남성26례,녀성30례;년령52 ～73세,평균년령61.8세.환자균행슬관절MRI검사,가소묘3D-FS-SPGR서렬,이술중행관절경탐사위금표준적진단효력,평개3D-FS-SPGR여T2WI서렬대연골손상여관절경하검사결과상부합적준학솔.결과 56개슬관절안조불동구역분위336개연골관절면.정상관절면점55.1％;표현위조기골관절염자위21.4％;중만기골관절염비솔위23.5％.3 D-FS-SPGR서렬대연골손상분급진단여관절경하진단상비일치솔위90.2％.3D-FS-SPGR서렬현시슬관절연골병변적령민도위93.1％,특이도위98.3％,Kappa치위0.849.T2WI서렬현시슬관절연골병변적령민도위84.4％,특이도위96.9％,Kappa치위0.671.결론 3D-FS-SPGR서렬MRI대연골손상적평개구유교고적령민도화특이도,대연골손상분급역구유교고적일치성.
Objective To analyze the 3 dimensional-fat suppression-spoiled gradient-recalled acquisition (3D-FS-SPGR) sequence in the diagnosis of knee articular cartilage injury.Methods A total of 56 knee osteoarthritis patients (26 males,30 females,ages 52-73 years,mean 61.8 years) treated in Department of Orthopedics,Chinese People's Liberation Army General Hospital between June 2013 and May 2014 were involved in this study.All patients underwent knee MRI,plus 3D-FS-SPGR sequence,arthroscopic exploration,and in contrast to the results of MRI results analysis,evaluation 3D-FS-SPGR and conventional sequence of cartilage damage consistent with the arthroscopic accuracy.Results Divided 56 knee joints into 336 cartilage articular surface,included 55.1％ normal articular surface,21.4％ early osteoarthritis and 23.5％ advanced osteoarthritis.The accordance of 3D-FS-SPGR sequence grading and arthroscopic was 90.2％.The sensitivity of 3D-FS-SPGR sequence was 93.1％,specificity was 98.3％,and Kappa value was 0.849.The sensitivity of T2WI sequence was 84.4％,specificity was 96.9％,and the Kappa value was 0.671.Conclusion For unicompartment osteoarthritis,MRI 3D-FS-SPGR sequence is effective in sensitivity and specificity of cartilage damage.
