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膝关节内骨与软骨关节内游离体的影像学检查:尸体中磁共振成像和磁共振关节造影与计算机断层扫描及计算机断层扫描关节造影的比较

Imaging of osseous and cartilaginous intraarticular bodies in the knee: comparison of MR imaging and MR arthrography with CT and CT arthrography in cadavers.

作者信息

Brossmann J, Preidler K W, Daenen B, Pedowitz R A, Andresen R, Clopton P, Trudell D, Pathria M, Resnick D

机构信息

Department of Radiology, Veterans Administration Medical Center, San Diego, CA 92161, USA.

出版信息

Radiology. 1996 Aug;200(2):509-17. doi: 10.1148/radiology.200.2.8685349.

DOI:10.1148/radiology.200.2.8685349
PMID:8685349
Abstract

PURPOSE

To compare magnetic resonance (MR) imaging and MR arthrography with computed tomography (CT) and CT arthrography in the detection of intraarticular bodies in the knee.

MATERIALS AND METHODS

Cuboid (3- or 6-mm-long sides) osseous and cartilaginous bodies were implanted in 16 cadaveric knee specimens. MR imaging was performed with T1-weighted spin-echo (SE), T2-weighted SE, proton-density-weighted SE, gradient recalled acquisition in the steady state (GRASS), and spoiled GRASS sequences. MR arthrography was performed in two phases with saline and 2 mmol/L gadopentetate dimeglumine. CT and CT arthrography were performed in the transaxial plane.

RESULTS

MR arthrography yielded the highest accuracy for the detection of osseous and cartilaginous bodies combined (92%) and was significantly (P < .01) better than MR imaging (57%-70%), CT arthrography (80%), and CT (74%). Accuracy of CT arthrography was significantly better than that of MR imaging and that of CT. Accuracy of saline-enhanced MR arthrography was significantly inferior (P < .001) to that of gadolinium-enhanced MR arthrography.

CONCLUSION

MR arthrography is the best imaging technique for detection of individual intraarticular bodies. CT arthrography is the second most accurate method. Spoiled GRASS and T2-weighted SE sequences are the most accurate at MR imaging. The presence of intraarticular fluid and performance of saline-enhanced MR arthrography improve detectability of intraarticular bodies.

摘要

目的

比较磁共振(MR)成像及MR关节造影与计算机断层扫描(CT)及CT关节造影在检测膝关节内游离体方面的效果。

材料与方法

将长方体状(边长3或6毫米)的骨性及软骨性物体植入16个尸体膝关节标本中。采用T1加权自旋回波(SE)、T2加权SE、质子密度加权SE、稳态梯度回波采集(GRASS)及扰相GRASS序列进行MR成像。分两个阶段用生理盐水和2毫摩尔/升钆喷酸葡胺进行MR关节造影。在横断面进行CT及CT关节造影。

结果

MR关节造影在检测骨性及软骨性物体方面综合准确率最高(92%),显著优于MR成像(57%-70%)、CT关节造影(80%)及CT(74%)(P <.01)。CT关节造影的准确率显著优于MR成像及CT。生理盐水增强的MR关节造影的准确率显著低于钆增强的MR关节造影(P <.001)。

结论

MR关节造影是检测单个关节内游离体的最佳成像技术。CT关节造影是第二准确的方法。扰相GRASS和T2加权SE序列在MR成像中最准确。关节内液体的存在及生理盐水增强的MR关节造影可提高关节内游离体的可检测性。

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