Lee Ji Hyun, Yoon Young Cheol, Park Ki Jeong, Wang Joon Ho
1 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea.
2 Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
AJR Am J Roentgenol. 2017 Jun;208(6):1304-1311. doi: 10.2214/AJR.16.17217. Epub 2017 Mar 16.
The purpose of this study was to compare 3D volume isotropic turbo spin-echo acquisition (VISTA) MRI with and without fat suppression for use in evaluating ligaments, menisci, and cartilage.
Two radiologists retrospectively and independently reviewed 71 MRI studies. Each study consisted of 3D intermediate-weighted VISTA images with fat suppression and without fat suppression. The presence of tears of the anterior cruciate and posterior cruciate ligaments, tears of the medial and lateral menisci, and cartilaginous defects was evaluated. Arthroscopic surgical findings were used as the standard of reference. Statistical analysis was performed to calculate the sensitivity, specificity, and accuracy of the two methods.
Mean specificity and accuracy for medial meniscal tears were significantly higher with VISTA (specificity, 95.0%; accuracy, 94.4%) than with fat-suppressed VISTA (FS-VISTA) (specificity, 81.3%; accuracy, 85.9%), and the difference was statistically significant (specificity, p = 0.003; accuracy, p = 0.004). Mean specificity for cartilaginous defects was also significantly higher with VISTA than with FS-VISTA (99.1% vs 96.8%, p = 0.039). There were no other significant differences between the two methods.
Three-dimensional VISTA MRI has higher specificity than FS-VISTA imaging for evaluation of medial meniscal tears and cartilaginous defects.
本研究的目的是比较有脂肪抑制和无脂肪抑制的三维容积各向同性涡轮自旋回波采集（VISTA）磁共振成像（MRI）在评估韧带、半月板和软骨方面的应用。
两名放射科医生对71项MRI研究进行回顾性独立评估。每项研究均包括有脂肪抑制和无脂肪抑制的三维中等加权VISTA图像。评估前交叉韧带和后交叉韧带撕裂、内侧和外侧半月板撕裂以及软骨缺损的情况。关节镜手术结果作为参考标准。进行统计分析以计算两种方法的敏感性、特异性和准确性。
对于内侧半月板撕裂，VISTA的平均特异性和准确性（特异性95.0%；准确性94.4%）显著高于脂肪抑制VISTA（FS-VISTA）（特异性81.3%；准确性85.9%），差异具有统计学意义（特异性，p = 0.003；准确性，p = 0.004）。对于软骨缺损，VISTA的平均特异性也显著高于FS-VISTA（99.1%对96.8%，p = 0.039）。两种方法之间没有其他显著差异。
在评估内侧半月板撕裂和软骨缺损方面，三维VISTA MRI比FS-VISTA成像具有更高的特异性。
