3.0 T磁共振T2-Mapping、3D-FSE-Cube与常规序列对膝关节软骨损伤分级对比分析

目的评估磁共振三维快速自旋回波脉冲序列(three-dimensional fast spin echo cube,3D-FSE-Cube)、T2-Mapping与常规序列对膝关节软骨损伤分级诊断的应用价值。材料与方法回顾性分析2016年3月至2016年12月就诊的膝关节外伤患者和骨性关节炎患者为研究对象,筛选出先后行膝关节MRI检查(T2-mapping、3D-FSE-Cube和常规序列)及关节镜手术治疗的患者63例。记录三种MRI序列及关节镜下对膝关节软骨损伤的分级。以关节镜为金标准,计算三种序列对膝关节软骨损伤的敏感度、特异度,并进行对比分析。结果三种磁共振序列评价膝关节软骨损伤总敏感度、特异度及Ⅰ、Ⅱ级损伤的敏感度差异均有统计学意义(P0.05),Ⅲ、Ⅳ级损伤的敏感度差异无统计学意义(P0.05)。进一步两两比较:T2-mapping序列对膝关节软骨Ⅰ级损伤的敏感度显著高于3D-FSE-Cube(P0.0125),二者对软骨损伤总敏感度、特异度及Ⅱ级损伤敏感度差异均无统计学意义(P0.0125);T2-mapping序列与3D-FSECube序列在评估膝关节软骨损伤的总敏感度及Ⅰ、Ⅱ级损伤敏感度均高于常规序列,而特异度均低于常规序列,差异均有统计学意义(P0.0125)。结论在膝关节软骨损伤分级诊断方面,T2-mapping和3D-FSE-Cube序列的敏感度较常规序列高,常规序列的特异度高于T2-mapping和3D-FSE-Cube序列。T2-mapping序列可以发现无明显形态学改变的膝关节软骨早期损伤,为临床早期诊治提供重要参考依据。

Comparative analysis of T2-mapping, 3D-FSE-Cube and conventional sequence in the classification of knee cartilage injury in 3.0 T MRI

Objective: To evaluate the value of 3D-FSE-Cube, T2-Mapping and conventional MRI sequences in grading diagnosis of knee cartilage injury. Materials and Methods: In this retrospective study, 63 patients with knee joint trauma or osteoarthritis who underwent not only knee joint MRI but also arthroscopic surgery from March 2016 to December 2016 in our hospital were included. Each knee cartilage injury classification diagnosis was respectively obtained by T2-mapping, 3D-FSE-Cube, conventional sequences and arthroscopy. Taking the classification diagnostic results of arthroscopy as gold standards, the sensitivity and specificity of the three sequences for the knee cartilage injury were calculated and compared. Results: The total sensitivity, specificity and sensitivity of grade Ⅰ and Ⅱ injury for knee cartilage were evaluated among three kinds of MRI sequences, and the differences were statistically significant (P<0.05). While the sensitivity of Ⅲ and Ⅳ grade injury had no significant differences (P>0.05). Further analysis of the results betweensequences, the sensitivity of T2-mapping sequence for grade Ⅰ knee cartilage injury was significantly higher than that of 3D-FSE-Cube sequence (P<0.0125). There was no significant difference in total sensitivity, specificity and sensitivity of grade Ⅱ injury for knee cartilage between T2-mapping and 3D-FSE-Cube sequence (P>0.0125). As for the total sensitivity and sensitivity of gradeⅠ and Ⅱ injury, T2-mapping sequence and 3D-FSE-Cube sequence were both higher than that of the conventional sequence, while the specificity of T2-mapping sequence and 3D- FSE-Cube sequence in diagnosis of the knee cartilage injury was lower than that of conventional sequences, the differences were statistically significant (P<0.0125). Conclusions: In the evaluation of knee cartilage injury, the sensitivity of T2-mapping sequence and 3D-FSE-Cube sequence were higher than that of conventional sequence, and the specificity of the conventional sequences was higher than that of T2-mapping sequence and 3D-FSE-Cube sequence. The T2-mapping sequence can indicate early articular cartilage injury without morphology change, which has a high clinical value to diagnose and treat early cartilage injury.