Gay S B, Chen N C, Burch J J, Gleason T R, Sagman A M
Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908.
Invest Radiol. 1993 Feb;28(2):142-5. doi: 10.1097/00004424-199302000-00011.
At many institutions, three-dimensional magnetic resonance imaging (MRI) is routinely used for examination of the knee. Multiplanar reconstruction (MPR) is a method of displaying three-dimensional datasets. The authors assessed the usefulness of MPR for evaluating knee MRI datasets by comparing readers' performance using MPR and conventional film MRIs.
Eight patients with internal derangement of the knee were studied. All had MRI datasets acquired in the sagittal plane using a three-dimensional gradient-echo fast imaging with steady-state precession (FISP) sequence. Arthroscopic surgery after MRI confirmed the presence of 6 anterior cruciate ligament (ACL) tears, 11 meniscal tears, and 5 normal menisci in this group. Four blinded readers, experienced in MRI of the knee, evaluated the images. The MRI datasets were then loaded onto a three-dimensional workstation and interpreted by the same readers using MPR. The MRI findings were correlated with arthroscopy.
For diagnosis of tears of the ACL, sensitivity was 96% and specificity was 100% for both films and MPR. For detecting meniscal tears, sensitivity was 55% and specificity was 90%, using the filmed images, versus 64% and 85%, respectively, with MPR. These differences were not statistically significant by the sign test. Total time (technologist processing time plus radiologist reading time) for MPR was greater than for film interpretation by a factor of 1.12 (P < .05), and radiologist reading time for MPR was greater by a factor of 1.88 (P < .05).
For sagittal three-dimensional FISP MRI datasets, real-time MPR is comparable with film interpretation for evaluation of ACL and meniscal injuries, but it increases the time required for diagnosis.
在许多机构中，三维磁共振成像（MRI）常用于膝关节检查。多平面重建（MPR）是一种显示三维数据集的方法。作者通过比较读者使用MPR和传统胶片MRI的表现，评估了MPR在评估膝关节MRI数据集方面的实用性。
对8例膝关节内部紊乱患者进行了研究。所有患者均使用三维梯度回波稳态进动快速成像（FISP）序列在矢状面获取了MRI数据集。MRI检查后进行的关节镜手术证实该组中有6例前交叉韧带（ACL）撕裂、11例半月板撕裂和5例半月板正常。4名对膝关节MRI有经验的盲法读者对图像进行了评估。然后将MRI数据集加载到三维工作站上，由相同的读者使用MPR进行解读。将MRI结果与关节镜检查结果进行关联。
对于ACL撕裂的诊断，胶片和MPR的敏感性均为96%，特异性均为100%。对于检测半月板撕裂，使用胶片图像时敏感性为55%，特异性为90%，而使用MPR时分别为64%和85%。通过符号检验，这些差异无统计学意义。MPR的总时间（技术人员处理时间加上放射科医生阅读时间）比胶片解读长1.12倍（P <.05），MPR的放射科医生阅读时间长1.88倍（P <.05）。
对于矢状面三维FISP MRI数据集，实时MPR在评估ACL和半月板损伤方面与胶片解读相当，但会增加诊断所需时间。
