不同MR扫描序列对髌股关节软骨病变的评价

目的　评价SE序列、FSE序列、二维SPGR序列及三维脂肪抑制SPGR序列对髌股关节软骨病变的诊断价值。方法　 5例尸体膝关节 ,关节腔内注射 40ml生理盐水。所有髌股关节均作常规自旋回波 (SE)序列T1WI、快速自旋回波(FSE)序列T2 WI和PDWI、二维毁损梯度回波 (2DSPGR)序列以及三维脂肪抑制毁损梯度回波 (3DFS SPGR)序列轴位扫描。计算每种序列诊断髌股关节软骨病变的敏感性、特异性和总符合率。结果　在 3DFS SPGR序列正常髌股关节软骨表现为三层结构 ,其诊断髌股关节软骨病变的敏感性、特异性和总符合率分别为 92 %、86%和 90 %。结论　在髌股关节软骨病变的诊断中 ,3DFS SPGR序列的特异性及敏感性较SE、FSE和 2DSPGR序列要高 ,是观察关节软骨结构的最佳方法。

Different MR Sequences in Evaluation of Abnormalities of Patellofemoral Joint Cartilage

Objective To evaluate the diagnostic value of spin echo(SE) sequence,fast spin echo(FSE)sequence,two dimensional spoiled gradient recalled echo(2D SPGR) sequence and three dimensional fat suppressed spoiled gradient recalled echo(3D FS SPGR) sequence in the assessment of abnormalities of patellofemoral joint cartilage.Methods Five cadaveric knees were injected 40ml of saline prior to imaging. The following sequences were used in imaging of all: T 1 weighted SE sequence, multiecho T 2 weighted and proton density weighted SE sequence, 2D SPGR sequence and a 3D FS SPGR sequence. The sensitivity,specificity and accuracy of each sequence were calculated. Results The 3D FS SPGR sequence provided the best depiction of cartilage structure and internal detail, the sensitivity,specificity and accuracy of which were 92%,86%,90%. Conclusion 3D FS SPGR sequence can provide higher sensitivity and specificity than SE, FSE and 2D SPGR sequences for the detection of patellofemoral joint cartilage abnormalities. 3D FS SPGR is the best sequence for chondral observation.