脂肪抑制三维稳态旋进快速成像FS-3D-FISP序列在诊断踝关节软骨损伤中的应用价值

Application value of FS-3D-FISP sequence in the diagnosis of ankle cartilage injury

目的 对照不同序列踝关节软骨病损的MRI特点与关节镜表现,评价特殊序列,即脂肪抑制三维稳态旋进快速成像FS-3D-FISP对软骨病变的诊断价值.方法 对因踝关节疼痛拟行踝关节镜检查的40例（41踝）患者,术前常规行T2加权快速自旋回波FSE-T2WI、质子密度加权快速自旋回波FSE-PDWI和FS-3D-FISP 3种MRI序列扫描,分别得到MRI分级结果,并与关节镜分级诊断结果进行比较.结果 以关节镜诊断为标准,FS-3D-FISP序列敏感度最高,可达92.9%.在敏感度上FS-3D-1 ISP〉FSE-FDWI〉FSE-T2WI,与关节镜诊断的一致性上：FS-3D-FISP的Kappa值达到0.7590,一致性高,也明显优于FSE-PDWI和FSE-T2WI （P〈0.01）.结论 FS-3D-FISP序列能够准确地反映软骨病变,并且能较真实体现早期的软骨病变,与关节镜诊断结果具有良好的一致性,而且通过三维重建对软骨病变进行立体定位诊断,能更准确地显示病变的部位及程度,并对其进行合理 分级,更好地指导临床决策.

Objective To compare several sequences of MRI and arthroscopy for detecting the ankle articular cartilage lesions and to evaluate the clinical outcome of special sequence of FS-3D-FISP.Methods Forty pailents （41 ankles） with iterative ankle pain who were scheduled for arthroseopy underwent MR scanning.including FS-3D-FISP.FSE T2WI and FSE PDWI sequences.The results of each sequence were then compared with the arthroseopic findings.Results Using arthroscopic results as the standard of reference,the FS-3D-FISP images had the higher sensitivity （92.86%） than the other two sequences.The FS-3D-FISP sequence wag well consistent with the result of arthroacopy. Kappa value （0.7590） was higher than the other two sequences （P〈0.01）.Conclusion As a favorable scanning sequence,FS-3D-FISP imaging can show the early-stage pathological changes of articular cartilage and it has an excellent correlation with the arthroseopic findings.A 3-D reconstruction is helpful to determine the location and the degree of lesion and obtain a more accurate classification to guide clinical decisions.