Department of Radiology, University of Wisconsin, 600 Highland Ave, Clinical Science Center, E3/311, Madison, WI 53792-3252, USA.
Radiology. 2010 Apr;255(1):117-27. doi: 10.1148/radiol.09091011. Epub 2010 Feb 19.
To compare the diagnostic performance of iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) gradient-recalled acquisition in steady-state (GRASS) imaging with a routine magnetic resonance (MR) imaging protocol for evaluating knee cartilage at 3.0 T in patients by using arthroscopy as the reference standard.
This prospective Health Insurance Portability and Accountability Act-compliant study was performed with a waiver of informed consent from the institutional review board. IDEAL GRASS was added to routine 3.0-T knee MR protocol performed in 95 symptomatic patients (48 males, mean age, 34.5 years; 47 females, mean age, 35.5 years) who underwent subsequent arthroscopic surgery. Radiologists used the routine MR protocol during the first review and IDEAL GRASS during the second to grade each articular surface and to determine the presence of meniscal tears. By using arthroscopy as the reference standard, the sensitivity, specificity, and accuracy of both imaging methods for detecting cartilage lesions and meniscal tears were determined.
By using the z test to compare parameters between methods, the respective sensitivity, specificity, and accuracy for detecting all 192 cartilage lesions were 68.5%, 92.6%, and 84.5% for IDEAL GRASS and 66.1%, 92.9%, and 83.9% for the routine MR protocol. There was no significant difference (P = .34-.83) in parameters between methods for detecting cartilage lesions. The respective parameters for detecting 50 medial meniscal tears were 85.0%, 91.1%, and 87.9% for IDEAL GRASS and 94.0%, 90.0%, and 92.1% for the routine MR protocol. The parameters for detecting 31 lateral meniscal tears were 58.0%, 90.6%, and 80.0% for IDEAL GRASS and 80.1%, 91.4%, and 87.9% for the routine MR protocol. The routine MR protocol had a significantly higher sensitivity for detecting medial meniscal tears (P = .04) and lateral meniscal tears (P = .01) and significantly higher accuracy for detecting lateral meniscal tears (P = .03) than IDEAL GRASS.
IDEAL GRASS has similar diagnostic performance as routine MR protocol for evaluating the articular cartilage of the knee in clinical patients at 3.0 T but has significantly lower sensitivity and accuracy for detecting meniscal tears.
通过关节镜作为参考标准，比较在 3.0T 磁共振成像（MRI）中使用常规 MRI 方案与迭代水脂分解和 echo 不对称最小二乘估计（IDEAL）梯度回波稳态（GRASS）成像评估膝关节软骨的诊断性能。
本前瞻性研究符合健康保险流通与责任法案（HIPAA）规定，经机构审查委员会豁免知情同意。在 95 例有症状的患者（48 例男性，平均年龄 34.5 岁；47 例女性，平均年龄 35.5 岁）中进行了这项研究，这些患者均接受了后续的关节镜手术。在第一次检查中，放射科医生使用常规的 3.0T 膝关节 MRI 方案，在第二次检查中使用 IDEAL GRASS 方案，以对每个关节面进行分级，并确定半月板撕裂的存在。以关节镜作为参考标准，确定两种成像方法检测软骨病变和半月板撕裂的敏感性、特异性和准确性。
通过使用 z 检验比较两种方法的参数，分别使用 IDEAL GRASS 和常规 MRI 方案检测 192 个软骨病变的敏感性、特异性和准确性为 68.5%、92.6%和 84.5%和 66.1%、92.9%和 83.9%。两种方法在检测软骨病变方面无显著差异（P =.34-.83）。分别使用 IDEAL GRASS 和常规 MRI 方案检测 50 例内侧半月板撕裂的参数为 85.0%、91.1%和 87.9%和 94.0%、90.0%和 92.1%。分别使用 IDEAL GRASS 和常规 MRI 方案检测 31 例外侧半月板撕裂的参数为 58.0%、90.6%和 80.0%和 80.1%、91.4%和 87.9%。常规 MRI 方案检测内侧半月板撕裂的敏感性显著高于 IDEAL GRASS（P =.04），检测外侧半月板撕裂的准确性显著高于 IDEAL GRASS（P =.01）。
在 3.0T 临床患者中，IDEAL GRASS 评估膝关节关节软骨的诊断性能与常规 MRI 方案相似，但检测半月板撕裂的敏感性和准确性明显较低。
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