联合稳态 5 分钟双回波分离回波和 2 分钟质子密度加权二维 FSE 序列进行全面的膝关节 MRI 评估。
Combined 5-minute double-echo in steady-state with separated echoes and 2-minute proton-density-weighted 2D FSE sequence for comprehensive whole-joint knee MRI assessment.
机构信息
Department of Radiology, Stanford University, Stanford, California, USA.
Department of Bioengineering, Stanford University, Stanford, California, USA.
出版信息
J Magn Reson Imaging. 2019 Jun;49(7):e183-e194. doi: 10.1002/jmri.26582. Epub 2018 Dec 23.
BACKGROUND
Clinical knee MRI protocols require upwards of 15 minutes of scan time.
PURPOSE/HYPOTHESIS: To compare the imaging appearance of knee abnormalities depicted with a 5-minute 3D double-echo in steady-state (DESS) sequence with separate echo images, with that of a routine clinical knee MRI protocol. A secondary goal was to compare the imaging appearance of knee abnormalities depicted with 5-minute DESS paired with a 2-minute coronal proton-density fat-saturated (PDFS) sequence.
STUDY TYPE
Prospective.
SUBJECTS
Thirty-six consecutive patients (19 male) referred for a routine knee MRI.
FIELD STRENGTH/SEQUENCES: DESS and PDFS at 3T.
ASSESSMENT
Five musculoskeletal radiologists evaluated all images for the presence of internal knee derangement using DESS, DESS+PDFS, and the conventional imaging protocol, and their associated diagnostic confidence of the reading.
STATISTICAL TESTS
Differences in positive and negative percent agreement (PPA and NPA, respectively) and 95% confidence intervals (CIs) for DESS and DESS+PDFS compared with the conventional protocol were calculated and tested using exact McNemar tests. The percentage of observations where DESS or DESS+PDFS had equivalent confidence ratings to DESS+Conv were tested with exact symmetry tests. Interreader agreement was calculated using Krippendorff's alpha.
RESULTS
DESS had a PPA of 90% (88-92% CI) and NPA of 99% (99-99% CI). DESS+PDFS had increased PPA of 99% (95-99% CI) and NPA of 100% (99-100% CI) compared with DESS (both P < 0.001). DESS had equivalent diagnostic confidence to DESS+Conv in 94% of findings, whereas DESS+PDFS had equivalent diagnostic confidence in 99% of findings (both P < 0.001). All readers had moderate concordance for all three protocols (Krippendorff's alpha 47-48%).
DATA CONCLUSION
Both 1) 5-minute 3D-DESS with separated echoes and 2) 5-minute 3D-DESS paired with a 2-minute coronal PDFS sequence depicted knee abnormalities similarly to a routine clinical knee MRI protocol, which may be a promising technique for abbreviated knee MRI.
LEVEL OF EVIDENCE
2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
背景
临床膝关节 MRI 方案需要 15 分钟以上的扫描时间。
目的/假设：比较 5 分钟 3D 双回波稳态（DESS）序列与单独回波图像显示膝关节异常的成像表现，与常规临床膝关节 MRI 方案比较。次要目标是比较 5 分钟 DESS 与 2 分钟冠状质子密度脂肪饱和（PDFS）序列联合显示膝关节异常的成像表现。
研究类型
前瞻性。
受试者
36 例连续患者（19 名男性）因常规膝关节 MRI 而就诊。
磁场强度/序列：3T 下的 DESS 和 PDFS。
评估
5 名肌肉骨骼放射科医生使用 DESS、DESS+PDFS 和常规成像方案评估所有图像中膝关节内部紊乱的存在情况，并评估他们对阅读的诊断信心。
统计检验
使用精确 McNemar 检验计算并比较 DESS 和 DESS+PDFS 与常规方案相比的阳性和阴性百分率一致（PPA 和 NPA）及其 95%置信区间（CI）。使用精确对称性检验测试 DESS 或 DESS+PDFS 的观察结果具有与 DESS+Conv 相同置信度评分的百分比。使用 Krippendorff 的 alpha 计算读者间的一致性。
结果
DESS 的 PPA 为 90%（88-92%CI），NPA 为 99%（99-99%CI）。与 DESS 相比，DESS+PDFS 的 PPA 增加到 99%（95-99%CI），NPA 增加到 100%（99-100%CI）（均 P <0.001）。DESS 在 94%的发现中具有与 DESS+Conv 相同的诊断信心，而 DESS+PDFS 在 99%的发现中具有相同的诊断信心（均 P <0.001）。所有读者在所有三种方案中均具有中度一致性（Krippendorff 的 alpha 47-48%）。
数据结论
1）5 分钟 3D-DESS 与分离回波和 2）5 分钟 3D-DESS 与 2 分钟冠状 PDFS 序列联合均与常规临床膝关节 MRI 方案相似地显示膝关节异常，这可能是缩短膝关节 MRI 的有前途的技术。
证据水平
2 技术功效：第 2 阶段 J. Magn. Reson. Imaging 2018。
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