磁共振集合序列与T2mapping序列在慢性冈上肌腱炎定量评估中的价值研究

The value of magnetic resonance image compilation and T2mapping sequence in the quantitative assessment of chronic supraspinatus tendonitis

目的探讨磁共振集合序列(magnetic resonance image compilation,MAGiC)与T2mapping序列在慢性冈上肌腱炎中的诊断价值,并比较两者在冈上肌腱扫描中的图像质量,以及两序列的T2值在冈上肌腱不同亚区的相关性。材料与方法回顾性收集2022年10月至2024年1月本院慢性冈上肌腱炎的患者30例(肌腱炎组)及健康体检者26例(对照组),均进行了常规MRI、T2mapping序列和MAGiC序列扫描。由两名放射科医生根据冈上肌腱走行将其分为外侧、中间、内侧亚区,并在MAGiC序列及T2mapping序列上测量不同亚区定量值。对比T2mapping序列第一回波图像与MAGiC T2WI的图像质量,并测量信号噪声比(signal to noise ratio,SNR)、对比噪声比(contrast to noise ratio,CNR)。采用Mann-Whitney U检验分析肌腱炎组与对照组在不同亚区各定量参数的差异以及两序列的图像质量。绘制受试者工作特征(receiver operating characteristic,ROC)曲线并计算曲线下面积(area under the curve,AUC),评价其对慢性冈上肌腱炎的诊断效能。对T2mapping序列与MAGiC序列测得的不同亚区T2值采用Pearson相关分析评价相关性。结果MAGiC序列重建图像MAGiC T2WI与T2mapping序列第一回波图像质量主观评分差异无统计学意义(Z=-1.535,P>0.05);MAGiC T2WI图像的CNR高于T2mapping序列第一回波图像[15.45(12.76,20.46)vs.9.94(8.74,12.23)],差异有统计学意义(Z=-2.473,P<0.001),而MAGiC T2WI图像的SNR低于T2mapping序列第一回波图像[2.49(2.16,2.71)vs.5.82(5.16,7.44)],差异有统计学意义(Z=-0.609,P<0.001);MAGiC序列与T2mapping序列的T2值在肌腱炎组外侧亚区、内侧亚区均高于对照组,差异有统计学意义(P<0.05);MAGiC序列的T1值在肌腱炎组外侧亚区高于对照组,差异有统计学意义(P<0.05)。外侧亚区T2mapping T2值、MAGiC T1、T2值诊断冈上肌腱炎的AUC分别为0.822、0.663、0.799;内侧亚区T2mapping T2值、MAGiC T2值诊断冈上肌腱炎的AUC分别为0.711、0.762。MAGiC序列T2值与T2mapping T2值在冈上肌腱外侧亚区、中间亚区、内侧亚区呈正相关(相关系数分别为0.736、0.437、0.464)。结论MAGiC定量图谱的T1、T2值与T2mapping T2值能够有效评估冈上肌腱内部成分的异质性,反映慢性冈上肌腱炎与正常肌腱内部成分的差异及肌腱自身的区域性差异,可为临床对冈上肌腱变性提供量化的客观依据。

Objective:To explore the diagnostic value of magnetic resonance image compilation(MAGiC)and T2mapping sequences in chronic supraspinatus tendinitis,and compare the image quality of the two in supraspinatus tendon scanning,and the T2 values of the two sequences in chronic supraspinatus tendonitis.Correlation of different subregions in supraspinatus tendonitis.Materials and Methods:A retrospective collection of 30 patients with chronic supraspinatus tendonitis(tendinitis group)and 26 healthy persons undergoing physical examination(control group)in our hospital from October 2022 to January 2024,and all underwent conventional MRI,T2mapping sequence and MAGiC sequence scanning.Two radiologists divided the supraspinatus tendon into lateral,middle,and medial subregions according to its course,and measured the T2 values of different subregions on the MAGiC sequence and T2mapping sequence.Compare the image quality of the first echo image of the T2mapping sequence and MAGiC T2WI,and measure the signal to noise ratio(SNR)and contrast to noise ratio(CNR).The Mann-Whitney U test was used to analyze the differences in quantitative parameters between the tendonitis group and the control group in different subregions as well as the image quality of the two sequences.Draw the receiver operating characteristic(ROC)curve and calculate the area under the curve(AUC)to evaluate its diagnostic performance for tendonitis.Pearson correlation analysis was used to evaluate the correlation between T2 values in different subregions measured by T2mapping sequence and MAGiC sequence.Results:There is no statistically significant difference in the subjective score of the first echo image quality between MAGiC T2WI and T2mapping sequences reconstructed images(Z=-1.535,P>0.05);the CNR of MAGiC T2WI images[15.45(12.76,20.46)]is higher than that of T2mapping sequences the first echo image[9.94(8.74,12.23)],the difference is statistically significant(Z=-2.473,P<0.001),while the SNR of the MAGiC T2WI image[2.49(2.16,2.71)]was lower than the first in the T2mapping sequence echo image[5.82(5.16,7.44)],the difference was statistically significant(Z=-0.609,P<0.001);the T2 values of MAGiC sequence and T2mapping sequence were both higher in the lateral subregion and medial subregion of the tendinitis group.In the control group,the difference was statistically significant(P<0.05);the T1 value of the MAGiC sequence in the lateral subregion of the tendonitis group was higher than that in the control group,and the difference was statistically significant(P<0.05).The AUC of MAGiC sequence T1 and T2 values in diagnosing supraspinatus tendinitis in the lateral sub-region are 0.663 and 0.799 respectively,and the AUC of T2 value in diagnosing supraspinatus tendinitis in the medial sub-region is 0.762;the T2mapping sequence T2 value in the lateral sub-region,the AUCs for diagnosing supraspinatus tendonitis in the medial subregion were 0.822 and 0.711 respectively.The MAGiC sequence T2 value and T2mapping T2 value were positively correlated in the lateral subregion,middle subregion,and medial subregion of the supraspinatus tendon(correlation coefficients were 0.736,0.437,0.464 respectively).Conclusions:The T1 and T2 values of the MAGiC quantitative map and T2mapping T2 values can effectively assess the heterogeneity of the internal components of the supraspinatus tendon,reflect the differences between the internal components of the normal tendon and the regional differences of the tendon itself,and provide an objective basis for the quantification of the supraspinatus tendon degeneration in clinical practice.