肩关节MR造影各向同性三维容积插入屏气序列评价盂唇撕裂

目的 评价肩关节MR造影各向同性三维容积插入屏气(VIBE)序列对盂唇撕裂的诊断价值。方法 由2名影像诊断医师独立回顾性对比分析79例肩关节造影常规二维序列图像和各向同性三维VIBE重建图像,判定有无盂唇撕裂,计算敏感度和特异度,比较常规二维序列与各向同性三维VIBE诊断价值及两名影像诊断医师评价的一致性。结果 79例患者中,肩关节镜证实上方盂唇撕裂(SLAP损伤)27例,前方盂唇撕裂44例,后方盂唇撕裂10例。肩关节MR造影各向同性三维VIBE以及常规二维序列对上方盂唇撕裂的敏感度分别为81.48%(22/27)~88.89%(24/27)、85.19%(23/27)~92.59%(25/27),特异度为82.69%(43/52)~84.62%(44/52)、84.62%(44/52)~86.54%(45/52);对前方盂唇撕裂的敏感度分别为88.64%(39/44)~90.91%(40/44)、90.91%(40/44)~95.45%(42/44),特异度为94.29%(33/35)~97.14%(34/35)、97.14%(34/35);对后方盂唇撕裂的敏感度分别为80.00%(8/10)~90.00%(9/10)、80.00%(8/10),特异度为92.75%(64/69)~95.65%(66/69)、94.20%(65/69)~95.65%(66/69)。2名影像诊断医师评价的一致性极好。各向同性三维VIBE和常规二维序列对于盂唇撕裂的诊断效能差异均无统计学意义。结论 肩关节MR造影各向同性三维VIBE序列成像是评价盂唇撕裂比较可靠的影像方法。

Diagnosis of labral tears with MR arthrography three-dimensional isotropic volumetric interpolated breath-hold examination sequence

Objective To observe the diagnostic value of shoulder MR arthrographic fat-suppressed three-dimensional (3D) isotropic volumetric interpolated breath-hold examination (VIBE) sequence for labral tears. Methods MR arthrographic fat-suppressed 3D isotropic VIBE and conventional T1W turbo spin-echo sequences were performed in 79 patients. The results of arthroscopy were regarded as gold standards, the sensitivity, specificity and accuracy of fat-suppressed 3D VIBE and conventional TSE images for detection of labral tears were calculated and compared by 2 radiologists, respectively. K values were calculated to quantify the level of interobserver agreement. Results Twenty-seven of the 79 patients were classified as SLAP lesions, 44 as anterior labral tears, and 10 as posterior labral tears. There was no statistical difference between fat-suppressed 3D isotropic VIBE and conventional TSE regarding the sensitivity (81.48%-88.89%, 85.19%-92.59%) and specificity (82.69%-84.62%, 84.62%-86.54%) of SLAP lesions, sensitivity (88.64%-90.91%, 90.91%-95.45%) and specificity (94.29%-97.14%, 97.14%) of anterior labral tears, nor sensitivity (80.00%-90.00%, 80%) and specificity (92.75%-95.65%, 94.20%-95.65%) of posterior labral tears. At interobserver comparison, the consistency was very good. Conclusion Fat-suppressed 3D isotropic VIBE MR arthrography is a reliable method to evaluate labral tears.