Department of Diagnostic Radiology, College of Medicine, Inje University Pusan Paik Hospital, Gaegeum-dong Jin-gu, Busan 614-735, Republic of Korea.
Radiology. 2012 Mar;262(3):921-31. doi: 10.1148/radiol.11111261. Epub 2012 Jan 20.
To determine the accuracy of a three-dimensional (3D) isotropic T1-weighted fast spin-echo (FSE) magnetic resonance (MR) sequence as compared with a conventional two-dimensional (2D) sequence in the diagnosis of rotator cuff tears and labral lesions.
Institutional review board approval was obtained, and the informed consent requirement was waived. Forty-nine patients who had undergone direct or indirect shoulder MR arthrography with the 2D T1-weighted FSE sequence and the 3D isotropic T1-weighted FSE sequence and subsequent arthroscopy were included. Each MR imaging sequence was independently scored by two readers retrospectively for the presence of full- or partial-thickness tears of the supraspinatus (SST) and infraspinatus (IST) tendons and the subscapularis tendon (SCT) and labral lesions. Diagnostic performance based on each sequence type was compared by using the area under the receiver operating characteristic curve (AUC).
Arthroscopic findings enabled confirmation of the presence of 17 full-thickness SST-IST tears, 18 partial-thickness SST-IST tears, four full-thickness SCT tears, 17 partial-thickness SCT tears, and 17 labral lesions. The AUCs for the readers using the 3D T1-weighted FSE sequence versus those obtained with the 2D sequence were 0.771-0.989 versus 0.837-0.998 for reader A and 0.771-0.989 versus 0.797-0.989 for reader B in the detection of rotator cuff tears and 0.885 versus 0.897 for reader A and 0.895 versus 0.895 for reader B in the detection of labral lesions. The mean AUCs between the 2D and 3D sequences were not significantly different, with the exception of partial-thickness SCT tears for one reader.
The accuracy of 3D isotropic FSE MR arthrography may be comparable with that of conventional 2D MR arthrography in the diagnosis of rotator cuff tears and labral lesions with a shorter imaging time.
与传统二维（2D）序列相比，确定三维（3D）各向同性 T1 加权快速自旋回波（FSE）磁共振（MR）序列在诊断肩袖撕裂和盂唇病变中的准确性。
本研究获得了机构审查委员会的批准，并豁免了知情同意书的要求。纳入 49 例患者，这些患者均接受过直接或间接肩关节 MR 关节造影检查，包括二维 T1 加权 FSE 序列和三维各向同性 T1 加权 FSE 序列，随后进行了关节镜检查。两名读者分别回顾性地对每个 MR 成像序列进行评分，以评估肩袖上、下肌腱（SST 和 IST）和肩胛下肌腱（SCT）的全层或部分撕裂以及盂唇病变的存在。使用受试者工作特征曲线下面积（AUC）比较每种序列类型的诊断性能。
关节镜检查结果证实存在 17 例全层 SST-IST 撕裂、18 例部分层 SST-IST 撕裂、4 例全层 SCT 撕裂、17 例部分层 SCT 撕裂和 17 例盂唇病变。使用 3D T1 加权 FSE 序列的读者的 AUC 值为 0.771-0.989，而使用 2D 序列的读者的 AUC 值为 0.837-0.998，对于读者 A，以及 0.771-0.989 对于读者 B，用于检测肩袖撕裂，对于读者 A 的 0.885 与 0.897 相比，对于读者 B 的 0.895 与 0.895 相比，用于检测盂唇病变。除一位读者的部分层 SCT 撕裂外，二维和三维序列之间的平均 AUC 无显著差异。
在诊断肩袖撕裂和盂唇病变方面，3D 各向同性 FSE MR 关节造影的准确性可能与传统 2D MR 关节造影相当，同时具有更短的成像时间。
