MR 3D-DESS和3D-True FISP对类风湿关节炎腕关节软骨损伤的诊断价值

目的 探讨3.0T MR三维双回波稳态(3D-DESS)序列及三维真实稳态进动快速成像(3D-True FISP)序列对类风湿关节炎(RA)腕关节软骨改变的应用价值.方法 对26例临床诊断为RA患者采用3D-DESS、3D-True FISP序列行腕关节扫描,共有20例患者完成2种序列扫描.观察该20例患者腕关节共340个关节面软骨形态学情况,按照形态学表现分为0、1、2级,分别计数3D-DESS、3D-True FISP序列所见腕关节软骨病变个数,比较2种序列对RA腕关节软骨病变个数检出的差异;同时计数20例腕关节出现扫描伪影例数.结果 3D-DESS与3D-True FISP序列发现腕关节软骨1级损伤个数分别为79个和50个,2级损伤个数分别为23个和33个,其差异有统计学意义(P<0.05).3D-True FISP序列共有14例患者出现低信号伪影,3D-DESS序列共有2例患者出现伪影.结论 3D-DESS序列相比3D-True FISP序列能更好地显示RA腕关节软骨改变,3D-DESS序列可以为RA的治疗及愈后判断提供一定的帮助.

The diagnostic value of MR 3D-DESS and 3D-True FISP in wrist-joint cartilage damage of rheumatoid arthritis

Objective To investigate the application significance of 3.0T MR three dimensional double-echo steady state(3D-DESS) and three dimensional-true fast imaging with steady-state procession(3D-True FISP) sequences in diagnosis of wrist cartilage of rheumatoid arthritis (RA).Methods 26 patients who were clinically diagnosed with RA underwent wrist MR scans with 3D-DESS and 3D-True FISP sequences, while both sequences' scanning were achieved on 20 of them.340 articular-surface morphological conditions' were observed,which were divided into level 0, level 1 and level 2 damages according to morphological performance,and recorded on 3D-DESS and 3D-True FISP sequence respectively.The diagnostic differences in the number of lesions were compared for two sequences.Results The numbers were 79 and 50 for level 1 damage and 23 and 33 for level 2 damage on 3D-DESS and 3D-True FISP sequence respectively (P<0.05).The artifacts were showed in 14 patients on 3D-True FISP,and only two patients on 3D-DESS.Conclusion 3D-DESS sequence does better than 3D-True FISP in displaying RA wrist cartilage,which is able to provide certain help for treatment and prognosis evaluation of RA.