脂肪抑制质子密度加权快速自旋回波序列在检测半月板损伤中的价值：与关节镜检查的比较

Value of fat-suppressed proton-density-weighted turbo spin-echo sequences in detecting meniscal lesions: comparison with arthroscopy.

作者信息

Schäfer F K W, Schäfer P J, Brossmann J, Frahm C, Hilgert R E, Heller M, Jahnke T

机构信息

Department of Diagnostic Radiology, Christian-Albrechts-Universitaet Kiel, Arnold-Heller-Strasse 9, D-24105 Kiel, Germany. fschaefer@uni-kiel-de

出版信息

Acta Radiol. 2006 May;47(4):385-90. doi: 10.1080/02841850600570482.

DOI:10.1080/02841850600570482

PMID:16739698

Abstract

PURPOSE

To evaluate fat-suppressed (FS) proton-density-weighted (PDw) turbo spin-echo (TSE) magnetic resonance imaging (MRI) compared to arthroscopy in the detection of meniscal lesions.

MATERIAL AND METHODS

In a prospective study, 31 knee joints were imaged on a 1.5T MR scanner before arthroscopy using the following sequences: (a) coronal and sagittal FS-PDw TSE (TR/TE: 4009/15 ms); (b) coronal T1w SE (TR/TE: 722/20 ms), and sagittal PDw TSE (TR/TE: 3800/15 ms). Other imaging parameters were: slice thickness 3 mm, FOV 160 mm, matrix 256 x 256. A total of 186 meniscal regions (62 menisci; anterior horn, body, posterior horn) were evaluated. Standard of reference was arthroscopy. Sensitivity, specificity, negative predictive value (npv), positive predictive value (ppv), and accuracy were calculated.

RESULTS

Arthroscopically, meniscal lesions were detected in 55/186 segments (35 medial and 20 lateral meniscal lesions). Sensitivity, specificity, npv, ppv, and accuracy for combination of coronal and sagittal FS PDw TSE were 91.4%, 98.3%, 95%, 97%, and 93.5% for the medial meniscus, and 90%, 98.6%, 97.3%, 94.7%, and 96.8% for the lateral. The results were comparable to the combination of coronal T1w SE and sagittal PDw TSE for the medial (88.6%, 98.3%, 93.4%, 96.9%, 91.4%) and the lateral (90%, 95.9%, 97.2%, 85.7%, 92.5%) meniscus.

CONCLUSION

FS PDw TSE-MR sequences are an excellent alternative for the detection of meniscal lesions in comparison with diagnostic arthroscopy.

摘要

目的

评估脂肪抑制（FS）质子密度加权（PDw）快速自旋回波（TSE）磁共振成像（MRI）与关节镜检查在半月板损伤检测中的对比情况。

材料与方法

在一项前瞻性研究中，31个膝关节在关节镜检查前于1.5T MR扫描仪上成像，使用以下序列：（a）冠状面和矢状面FS - PDw TSE（TR/TE：4009/15 ms）；（b）冠状面T1w SE（TR/TE：722/20 ms），以及矢状面PDw TSE（TR/TE：3800/15 ms）。其他成像参数为：层厚3mm，视野160mm，矩阵256×256。总共评估了186个半月板区域（62个半月板；前角、体部、后角）。参考标准为关节镜检查。计算敏感性、特异性、阴性预测值（npv）、阳性预测值（ppv）和准确性。

结果

关节镜检查发现，186个节段中有55个存在半月板损伤（35个内侧半月板损伤和20个外侧半月板损伤）。冠状面和矢状面FS PDw TSE联合检查对于内侧半月板的敏感性、特异性、npv、ppv和准确性分别为91.4%、98.3%、95%、97%和93.5%，对于外侧半月板分别为90%、98.6%、97.3%、94.7%和96.8%。结果与冠状面T1w SE和矢状面PDw TSE联合检查对于内侧半月板（88.6%、98.3%、93.4%、96.9%、91.4%）和外侧半月板（90%、95.9%、97.2%、85.7%、92.5%）的情况相当。