踝关节软骨损伤：磁共振关节造影与CT关节造影的比较
Cartilage lesions in the ankle joint: comparison of MR arthrography and CT arthrography.
作者信息
Schmid M R, Pfirrmann C W A, Hodler J, Vienne P, Zanetti M
机构信息
Department of Radiology, Orthopedic University Hospital Balgrist, Forchstrasse 340, 8008 Zurich, Switzerland.
出版信息
Skeletal Radiol. 2003 May;32(5):259-65. doi: 10.1007/s00256-003-0628-y. Epub 2003 Apr 8.
OBJECTIVE
To compare MR arthrography and CT arthrography for the evaluation of cartilage lesions in the ankle joint.
DESIGN AND PATIENTS
Thirty-six consecutive patients with clinically suspected cartilage lesions were prospectively included in the study. A 1:1 mixture of diluted gadoteridol (4 mmol/l) and iopamidol (300 mg iodine/ml) was injected. The articular cartilages of the talus, tibia, and fibula were analyzed separately by two musculoskeletal radiologists. A review panel consisting of two musculoskeletal radiologists and an orthopedic surgeon represented the standard of reference.
RESULTS
For reader 1 accuracy of MR arthrography in the talus/tibia/fibula (88%/88%/94%) was slightly inferior to CT arthrography (90%/94%/92%). For reader 2, the accuracy was 76%/78%/83% for MR arthrography, and 92%/93%/92% for CT arthrography, respectively. Interobserver agreement for MR arthrography was 79%/74%/89% (kappa 0.47/0.34/0.27), while interobserver agreement for CT arthrography was 89%/90%/89% (kappa 0.69/0.54/0.54).
CONCLUSION
CT arthrography appears to be more reliable than MR arthrography for the detection of cartilage lesions in the ankle joint.
目的
比较磁共振关节造影（MR arthrography）和CT关节造影在评估踝关节软骨损伤中的应用。
设计与患者
本研究前瞻性纳入了36例临床怀疑有软骨损伤的连续患者。注射稀释的钆特醇（4 mmol/l）和碘帕醇（300 mg碘/ml）的1:1混合液。由两名肌肉骨骼放射科医生分别分析距骨、胫骨和腓骨的关节软骨。由两名肌肉骨骼放射科医生和一名骨科医生组成的评审小组作为参考标准。
结果
对于阅片者1，距骨/胫骨/腓骨的MR关节造影准确性（88%/88%/94%）略低于CT关节造影（90%/94%/92%）。对于阅片者2，MR关节造影的准确性分别为76%/78%/83%，CT关节造影为92%/93%/92%。MR关节造影的观察者间一致性为79%/74%/89%（kappa值0.47/0.34/0.27），而CT关节造影的观察者间一致性为89%/90%/89%（kappa值0.69/0.54/0.54）。
结论
在检测踝关节软骨损伤方面，CT关节造影似乎比MR关节造影更可靠。
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