Department of Clinical Radiology, University Hospitals Munich, Marchioninistrasse 15, 81377 Munich, Germany.
Eur J Radiol. 2012 Nov;81(11):3441-9. doi: 10.1016/j.ejrad.2012.04.020. Epub 2012 May 12.
To evaluate the clinical usefulness of an optimized 3D-Fast-Spin-Echo-sequence (3D-SPACE) in combination with a 15-channel knee-coil for 3D-imaging of the knee at 3T.
15 volunteers and 50 consecutive patients were examined at 3 T with fat-saturated moderately T2-weighted 3D-SPACE (Voxel-size (VS): 0.6 mm×0.5 mm×0.5 mm/acquisition-time (AT) 10:44 min) using a 15-channel knee-coil. Flip angle optimization and radial k-space reordering were applied. Signal- and contrast-to-noise-ratios (SNR, CNR) were compared to non-optimized 3D-SPACE (8-channel knee-coil) and conventional 2D-FSE (VS: 0.4 mm×0.4 mm×3 mm/total AT: 12 min). Two radiologists independently rated depiction of internal knee structures and assessed detection and depiction of cartilage and meniscus abnormalities compared to conventional 2D-FSE-sequences. Sensitivity and specificity were calculated for a subgroup with arthroscopy as reference standard. Statistical analysis was performed with paired t-tests, confidence intervals and weighted-κ-coefficients.
SNR and CNR particularly of fluid/cartilage of optimized 3D-SPACE were significantly higher (p<0.05) than of the non-optimized 3D-sequence and conventional 2D-sequence. Blurring and image inhomogeneity were reduced in the optimized sequence. The thin slice-thickness was beneficial for depiction of problematical anatomical structures such as meniscal roots. 3D-SPACE showed significantly higher diagnostic confidence (p<0.05) for diagnosis of cartilage lesions of the femoral trochlea. Overall sensitivity and specificity of 3D-SPACE and 2D-FSE for cartilage lesions was 82.3%/80.2% and 79.4%/84.2% and 100%/86.4% and 92.3%/81.8% for meniscus lesions.
Optimized 3D-SPACE provides significantly higher signal and contrast compared to conventional 2D-FSE, particularly for fluid and cartilage, leading to improved diagnostic confidence, particularly in problematic areas, such as the femoral trochlea.
评估优化的 3D-Fast-Spin-Echo 序列（3D-SPACE）与 15 通道膝关节线圈联合应用于 3T 膝关节 3D 成像的临床实用性。
在 3T 下使用脂肪饱和中度 T2 加权 3D-SPACE（体素大小（VS）：0.6mm×0.5mm×0.5mm/采集时间（AT）10:44 分钟）对 15 名志愿者和 50 名连续患者进行检查，使用 15 通道膝关节线圈。应用翻转角优化和径向 K 空间重排。比较信号和对比噪声比（SNR、CNR）与非优化 3D-SPACE（8 通道膝关节线圈）和常规 2D-FSE（VS：0.4mm×0.4mm×3mm/总 AT：12 分钟）。两名放射科医生独立评估内部膝关节结构的显示情况，并评估与常规 2D-FSE 序列相比软骨和半月板异常的检测和显示情况。对于以关节镜为参考标准的亚组，计算敏感性和特异性。采用配对 t 检验、置信区间和加权κ系数进行统计分析。
优化 3D-SPACE 的 SNR 和 CNR，特别是液体/软骨的 SNR 和 CNR，明显高于非优化 3D 序列和常规 2D 序列（p<0.05）。在优化序列中，模糊度和图像不均匀性降低。薄的切片厚度有利于显示半月板根部等有问题的解剖结构。3D-SPACE 对股骨滑车软骨病变的诊断信心明显更高（p<0.05）。3D-SPACE 和 2D-FSE 对软骨病变的总体敏感性和特异性分别为 82.3%/80.2%和 79.4%/84.2%，对半月板病变的总体敏感性和特异性分别为 100%/86.4%和 92.3%/81.8%。
与常规 2D-FSE 相比，优化的 3D-SPACE 提供了更高的信号和对比度，特别是对液体和软骨，从而提高了诊断信心，特别是在股骨滑车等有问题的区域。
