水激发三维VIBE肩关节MR造影对Bankart病变的评价

目的评价肩关节MR造影水激发三维容积内插梯度回波(volumetric interpolated breath-hold examination,VIBE)序列对Bankart病变的诊断价值。资料与方法由2名影像诊断医师独立回顾99例肩关节MR造影常规序列和三维VIBE重建图像,判定有无Bankart病变以及骨性Bankart病变,计算其敏感性和特异性。采用McNemar检验评价常规序列与三维VIBE的诊断价值差异是否存在统计学意义。结果 99例患者中,关节镜证实前下方盂唇完整41例,Bankart病变58例,其中26例为骨性Bankart病变。三维VIBE对Bankart病变的敏感性、特异性分别为91.38%～93.10%和95.12%～97.56%;对骨性Bankart病变分别为96.15%和95.89%～97.26%。常规序列对Bankart病变的敏感性、特异性分别为91.38%～96.55%和97.56%;对骨性Bankart病变分别为42.31%～50%和97.26%～100%。三维VIBE和常规序列对于Bankart病变的诊断性能差异无统计学意义,但前者判断骨性Ban-kart病变的敏感性显著优于后者。结论在肩关节MR造影中,水激发三维VIBE序列可全面评价Bankart病变。

MR Arthrographic 3D VIBE Sequence for Bankart Lesions at 3.0-T

Objective To evaluate the diagnostic value of shoulder MR arthrographic three dimensional(3D) volumetric interpolated breath hold examination(VIBE) sequence in Bankart lesions.Materials and Methods Water excitation 3D VIBE and conventional T1-weighted turbo spin-echo sequences were performed in 99 patients with shoulder MR arthrography.According to the gold standard——the results of arthroscopy,sensitivity and specificity of 3D VIBE and conventional T1-weighted images for detection of Bankart lesions and bony Bankart lesions were calculated and compared using paired McNemar test.K values were calculated to quantify the level of interobserver agreement.Results 58 of the 99 patients were classified as Bankart lesions,including 26 bony Bankart lesions at arthroscopy.Other 41 were found with intact anterior-inferior labrum.The sensitivity and specificity had no statistically significant differences of Bankart lesions between 3D VIBE and conventional T1-weighted images(91.38%-93.10% versus 91.38%-96.55% and 95.12%-97.56% versus 97.56%).3D VIBE was significantly higher sensitivity than conventional T1-weighted images in detecting bony Bankart lesions(96.15% versus 42.31%-50%),but not with specificity(95.89%-97.26% versus 97.26%-100%).The interobserver agreements were excellent.Conclusion MR arthrographic 3D VIBE is a comprehensive method for evaluating Bankart lesions.