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多序列磁共振成像提高成人肘关节软骨损伤诊断准确性的临床研究

Clinical study on improving the diagnostic accuracy of adult elbow joint cartilage injury by multisequence magnetic resonance imaging.

作者信息

Ding Wei-Wei, Ding Lei, Li Li, Zhang Pan, Gong Rui, Li Jian, Xu Meng-Ying, Ding Feng, Chen Bing

机构信息

Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 198793, Ningxia Hui Autonomous Region,

Department of Emergency, The First People's hospital of Yinchuan in Ningxia, Yinchuan 198794, Ningxia Hui Autonomous Region, China.

出版信息

World J Clin Cases. 2024 Sep 6;12(25):5673-5680. doi: 10.12998/wjcc.v12.i25.5673.

Abstract

BACKGROUND

Due to frequent and high-risk sports activities, the elbow joint is susceptible to injury, especially to cartilage tissue, which can cause pain, limited movement and even loss of joint function.

AIM

To evaluate magnetic resonance imaging (MRI) multisequence imaging for improving the diagnostic accuracy of adult elbow cartilage injury.

METHODS

A total of 60 patients diagnosed with elbow cartilage injury in our hospital from January 2020 to December 2021 were enrolled in this retrospective study. We analyzed the accuracy of conventional MRI sequences (T1-weighted imaging, T2-weighted imaging, proton density weighted imaging, and T2 star weighted image) and Three-Dimensional Coronary Imaging by Spiral Scanning (3D-CISS) in the diagnosis of elbow cartilage injury. Arthroscopy was used as the gold standard to evaluate the diagnostic effect of single and combination sequences in different injury degrees and the consistency with arthroscopy.

RESULTS

The diagnostic accuracy of 3D-CISS sequence was 89.34% ± 4.98%, the sensitivity was 90%, and the specificity was 88.33%, which showed the best performance among all sequences ( < 0.05). The combined application of the whole sequence had the highest accuracy in all sequence combinations, the accuracy of mild injury was 91.30%, the accuracy of moderate injury was 96.15%, and the accuracy of severe injury was 93.33% ( < 0.05). Compared with arthroscopy, the combination of all MRI sequences had the highest consistency of 91.67%, and the kappa value reached 0.890 ( < 0.001).

CONCLUSION

Combination of 3D-CISS and each sequence had significant advantages in improving MRI diagnostic accuracy of elbow cartilage injuries in adults. Multisequence MRI is recommended to ensure the best diagnosis and treatment.

摘要

背景

由于频繁进行高风险体育活动,肘关节易受损伤,尤其是软骨组织,可导致疼痛、活动受限甚至关节功能丧失。

目的

评估磁共振成像(MRI)多序列成像对提高成人肘关节软骨损伤诊断准确性的作用。

方法

本回顾性研究纳入了2020年1月至2021年12月在我院诊断为肘关节软骨损伤的60例患者。分析常规MRI序列(T1加权成像、T2加权成像、质子密度加权成像和T2*加权成像)及螺旋扫描三维冠状动脉成像(3D-CISS)对肘关节软骨损伤的诊断准确性。以关节镜检查作为金标准,评估不同损伤程度下单序列及联合序列的诊断效果以及与关节镜检查的一致性。

结果

3D-CISS序列的诊断准确性为89.34%±4.98%,敏感性为90%,特异性为88.33%,在所有序列中表现最佳(<0.05)。全序列联合应用在所有序列组合中准确性最高,轻度损伤的准确性为91.30%,中度损伤的准确性为96.15%,重度损伤的准确性为93.33%(<0.05)。与关节镜检查相比,所有MRI序列联合的一致性最高,为91.67%,kappa值达到0.890(<0.001)。

结论

3D-CISS与各序列联合在提高成人肘关节软骨损伤MRI诊断准确性方面具有显著优势。建议采用多序列MRI以确保最佳的诊断和治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4629/11263068/e20a55a68035/WJCC-12-5673-g001.jpg

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