Li X, Yu C, Wu H, Daniel K, Hu D, Xia L, Pan C, Xu A, Hu J, Wang L, Peng W, Li F
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
Clin Radiol. 2009 Oct;64(10):1000-8. doi: 10.1016/j.crad.2009.07.008. Epub 2009 Aug 20.
To prospectively compare the accuracy of three-dimensional fast imaging employing steady-state acquisition (3D FIESTA) sequences with that of fat-suppressed three-dimensional spoiled gradient-recalled (3D SPGR) in the diagnosis of knee articular cartilage lesions, using arthroscopy as the reference standard.
Fifty-eight knees in 54 patients (age range 21-82 years; mean 36 years) were prospectively evaluated by using sagittal 3D FIESTA and sagittal fat-suppressed 3D SPGR sequences. Articular cartilage lesions were graded on MRI and during arthroscopy with a modified Noyes scoring system. Sensitivity, specificity, and accuracy were assessed. Interobserver agreement was determined with kappa statistics.
The performance of 3D FIESTA sequences (sensitivity, specificity, and accuracy were 80, 94, and 92%, respectively, for reader 1 and 76, 94, and 90%, respectively, for reader 2) was similar to that of fat-suppressed 3D SPGR sequences (sensitivity, specificity, and accuracy were 82, 92, and 90%, respectively, for reader 1 and 82, 90, and 88%, respectively, for reader 2) in the detection of knee articular cartilage lesions. The interobserver agreement varied from fair to good to excellent (kappa values from 0.43-0.83).
3D FIESTA has good diagnostic performance, comparable with fat-suppressed 3D SPGR in evaluating knee cartilage lesions, and it can be incorporated into routine knee MRI protocols due to the short acquisition time.
以前瞻性方式比较采用稳态采集的三维快速成像（3D FIESTA）序列与脂肪抑制三维扰相梯度回波（3D SPGR）序列在诊断膝关节软骨损伤中的准确性，以关节镜检查作为参考标准。
对54例患者（年龄范围21 - 82岁；平均36岁）的58个膝关节进行前瞻性评估，采用矢状面3D FIESTA序列和矢状面脂肪抑制3D SPGR序列。在MRI及关节镜检查时，使用改良的诺伊斯评分系统对关节软骨损伤进行分级。评估敏感性、特异性和准确性。通过kappa统计量确定观察者间的一致性。
在检测膝关节软骨损伤方面，3D FIESTA序列（读者1的敏感性、特异性和准确性分别为80%、94%和92%，读者2分别为76%、94%和90%）的表现与脂肪抑制3D SPGR序列（读者1的敏感性、特异性和准确性分别为82%、92%和90%，读者2分别为82%、90%和88%）相似。观察者间的一致性从一般到良好再到优秀（kappa值为0.43 - 0.83）。
3D FIESTA具有良好的诊断性能，在评估膝关节软骨损伤方面与脂肪抑制3D SPGR相当，且由于采集时间短，可纳入常规膝关节MRI检查方案。
