RECOVER Injury Research Centre, NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Brisbane, Australia.
Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
Eur Spine J. 2019 May;28(5):1180-1187. doi: 10.1007/s00586-018-05868-0. Epub 2019 Jan 2.
Lateral atlantoaxial (LAA) joint meniscoid composition may have clinical significance in patients following neck trauma. However, the existing method of radiologically assessing meniscoid composition has an inherent element of subjectivity, which could contribute to measurement variability. The present study sought to investigate the accuracy of two-point Dixon fat/water separation MRI as a quantitative assessment of LAA joint meniscoid composition.
Sixteen LAA joint meniscoids were excised from four cadavers (mean [SD] age 79.5 [3.7] years; one female) following cervical spine MRI (two-point Dixon, T1-weighted VIBE and T2-weighted SPACE sequences). Composition of LAA joint meniscoids was undertaken by (1) histological examination by light microscopy, (2) calculation of fat fraction by Dixon MRI (both in-phase/opposed-phase and fat/water methods), and (3) the existing method of considering VIBE and SPACE signal intensities. Analysis was performed using the kappa statistic with linear weighting.
Microscopy revealed three, five, and eight meniscoids to be composed of adipose, fibroadipose, and fibrous tissues, respectively. Dixon sequence MRI classified 11 of these meniscoids correctly, with 'substantial' level of agreement (In-phase/Opp-phase kappa statistic = 0.78 [95% CI 0.38, 1.17]; fat/water kappa statistic = 0.72 [95% CI 0.32, 1.11]). Level of agreement between microscopy and the VIBE and SPACE method was 'slight' (kappa statistic = 0.02 [95% CI - 0.34, 0.38]).
Findings suggest that Dixon fat/water separation MRI may have superior utility in the assessment of LAA joint meniscoid composition than the existing method of considering VIBE and SPACE signal intensities. These slides can be retrieved under Electronic Supplementary Material.
外侧寰枢（LAA）关节半月板样结构在颈部创伤患者中可能具有临床意义。然而，现有的放射学评估半月板样结构的方法存在固有主观性，这可能导致测量变异性。本研究旨在探讨两点 Dixon 脂肪/水分离 MRI 作为 LAA 关节半月板样结构定量评估的准确性。
从四名尸体（平均[标准差]年龄 79.5[3.7]岁；女性 1 名）的颈椎 MRI（两点 Dixon、T1 加权 VIBE 和 T2 加权 SPACE 序列）中切除 16 个 LAA 关节半月板样结构。LAA 关节半月板样结构的组成采用（1）组织学检查（光镜）、（2）Dixon MRI 计算脂肪分数（同相位/反相位和脂肪/水方法）以及（3）现有的考虑 VIBE 和 SPACE 信号强度的方法进行评估。分析采用线性加权的 kapp 统计量进行。
显微镜显示，3 个、5 个和 8 个半月板样结构分别由脂肪、纤维脂肪和纤维组织组成。Dixon 序列 MRI 正确分类了其中的 11 个半月板样结构，具有“高度”一致性（同相位/反相位 kapp 统计量=0.78[95%CI 0.38, 1.17]；脂肪/水 kapp 统计量=0.72[95%CI 0.32, 1.11]）。显微镜与 VIBE 和 SPACE 方法之间的一致性“轻微”（kapp 统计量=0.02[95%CI -0.34, 0.38]）。
研究结果表明，Dixon 脂肪/水分离 MRI 在评估 LAA 关节半月板样结构方面可能优于考虑 VIBE 和 SPACE 信号强度的现有方法。这些幻灯片可以在电子补充材料中检索。
