Department of Orthopedics and Rehabilitation, Yale University School of Medicine, 333 Cedar Street PO Box 208042, New Haven, CT 06520-8042, United States.
Eur J Radiol. 2012 Jul;81(7):1637-43. doi: 10.1016/j.ejrad.2011.04.072. Epub 2011 Jun 17.
We sought to retrospectively compare the accuracy of a three-dimensional fat-suppressed, fast spin-echo sequences acquired in the sagittal plane, with multiplanar reconstructions to that of two-dimensional fat-suppressed, fast spin echo sequences acquired in three planes on a 3T MR system for the evaluation of articular cartilage in the knee.
Our study group consisted of all patients (N=34) that underwent 3T MR imaging of the knee at our institution with subsequent arthroscopy over an 18-month period. There were 21 males and 13 females with an average age of 36 years. MR images were reviewed by 3 musculoskeletal radiologists, blinded to operative results. 3D and 2D sequences were reviewed at different sittings separated by 4 weeks to prevent bias. Six cartilage surfaces were evaluated both with MR imaging and arthroscopically with a modified Noyes scoring system and arthroscopic results were used as the gold standard. Sensitivity, specificity, and accuracy were calculated for each reader along with Fleiss Kappa assessment agreement between the readers. Accuracies for each articular surface were compared using a difference in proportions test with a 95% confidence interval and statistical significance was calculated using a Fisher's Exact Test.
Two hundred and four articular surfaces were evaluated and 49 articular cartilage lesions were present at arthroscopy. For the patellofemoral surfaces, the sensitivity, specificity, and accuracy were 76.5%, 83%, and 78.2% for the 3D sequences and were 82.3%, 76%, and 82% respectively for the 2D sequences. For the medial compartment surfaces, the sensitivity, specificity, and accuracy were 81.1%, 65.1%, and 78.5% for the 3D sequences and were 82.5%, 48%, and 76.7% respectively for the 2D sequences. For the lateral compartment surfaces, the sensitivity, specificity, and accuracy were 89.3%, 39%, and 79.5% for the 3D sequences and were 94.7%, 18.8%, and 79.5% respectively for the 2D sequences. The accuracies were not significantly different between 3D and 2D sequences. Fleiss Kappa agreement values for the assessment of inter-observer agreement ranged from substantial for the patella and medial femur to moderate for the trochlea and fair for the medial tibia and lateral compartment.
There was no significant difference in accuracy for the evaluation of articular cartilage of a single three-dimensional, fast spin echo sequence with multi-planar reformatted images vs. two-dimensional, fast spin echo sequences acquired in all three imaging planes in the knee.
我们旨在回顾性比较在矢状面采集的三维脂肪抑制快速自旋回波序列与在 3T MR 系统的三个平面采集的二维脂肪抑制快速自旋回波序列的多平面重建的准确性，以评估膝关节的关节软骨。
我们的研究组包括在我院接受膝关节 3T MR 成像检查且随后在 18 个月期间进行关节镜检查的所有患者（N=34）。其中男性 21 例，女性 13 例，平均年龄 36 岁。3 名肌肉骨骼放射科医生对 MR 图像进行了盲法评估，与手术结果无关。3D 和 2D 序列分别在相隔 4 周的不同时间进行评估，以防止出现偏倚。使用改良的 Noyes 评分系统对 6 个软骨表面进行评估，并与关节镜检查结果进行比较，以关节镜检查结果作为金标准。为每位读者计算了敏感性、特异性和准确性，并使用 Fleiss Kappa 评估了读者之间的一致性。使用具有 95%置信区间的比例差异检验比较每个关节表面的准确性，并使用 Fisher's Exact Test 计算统计学意义。
共评估了 204 个关节表面，关节镜检查发现 49 个关节软骨病变。对于髌股关节面，3D 序列的敏感性、特异性和准确性分别为 76.5%、83%和 78.2%，2D 序列分别为 82.3%、76%和 82%。对于内侧间室表面，3D 序列的敏感性、特异性和准确性分别为 81.1%、65.1%和 78.5%，2D 序列分别为 82.5%、48%和 76.7%。对于外侧间室表面，3D 序列的敏感性、特异性和准确性分别为 89.3%、39%和 79.5%，2D 序列分别为 94.7%、18.8%和 79.5%。3D 和 2D 序列之间的准确性没有显著差异。评估观察者间一致性的 Fleiss Kappa 一致性值范围从髌骨关节和股骨内侧的中等到滑车和胫骨内侧和外侧间室的适度。
在评估膝关节单个三维快速自旋回波序列与多平面重建图像与二维快速自旋回波序列的准确性方面，没有显著差异。
