磁共振敏感序列与关节镜在膝关节软骨病变中的对比研究

The Contrast Study between the MR Sensitive Sequence and Arthrosocope on the Articular Cartilage Degeneration in the Knee

目的评价软骨敏感序列脂肪抑制梯度回波序列(FS-GRE)、脂肪抑制快速自旋回波序列(FS-FSE)及三维脂肪抑制扰相梯度回波序列(3D-FS-SPGR)诊断膝关节软骨病变的价值。资料与方法对36例经临床证实为骨性关节炎的患者行MRI常规、FS-GRE、FS-FSE及3D-FS-SPGR序列扫描,通过三种序列对膝关节软骨病变的显示并与关节镜对照,分析三种序列诊断软骨病变的可行性。结果 36例患者三种序列诊断膝关节软骨病变的结果与关节镜一致,3D-FS-SPGR序列的敏感性为99.2%,特异性为94.4%;FS-GRE序列的敏感性为98.8%,特异性为86.1%;FS-FSE序列的敏感性为97.2%,特异性为83.3%,Kappa均>0.75,其中FS-FSE序列与关节镜的一致性相对较差(Kappa=0.796);3D-FS-SPGR序列诊断膝关节软骨病变与关节镜的一致性最好(Kappa=0.937)。结论 3D-FS-SPGR序列诊断膝关节软骨病变与关节镜有较高的一致性,可以作为膝关节软骨病变的常规扫描序列。

Purpose To evaluate the significance of some MR sensitive sequences, including fat-suppressed gradient-recalled echo （FS-GRE） , fat-suppressed fast spinal echo （FS-FSE） and fat-suppressed three-dimensional spoiled gradient-recalled sequence （3D-FS-SPGR） , in the diagnosis of articular cartilage degeneration. Materials and Methods 36 cases with osteoarthritis in the knee joint were routinely underwent MRI FS-GRE, FS-FSE and 3D-FS-SPGR sequences scanning. These results were compared with the pathological changes of cartilage by arthroscope in order to analyze the possibility for these three MRI sequences to diagnose the cartilage degeneration. Results All the patients accepted the examination with both arthroscope and the three MRI sequences designated above. The diagnosing results from MRI FS-GRE, FS-FSE and 3D-FS-SPGR sequences were consistent with those by arthroscope, 3D-FS-SPGR sequence＇ s sensitivity arrived at 99.2% and its specificity was 94.4%, FS-GRE sequence＇ s sensitivity arrived at 98.8% and its specificity was 86.1%, FS-FSE sensitivity arrived at 97.2% and its specificity was 83.3%, all the Kappas〉0.75. The FS-FSE was relatively unsenstive and the 3D-FS- SPGR was the best to show the pathological changes of cartilage.. The Kappa value was 0.796 and 0.937, respectively. Conclusion The 3D-FS-SPGR sequence presents a higher consistency with the anthroscope in showing the pathological changes of cartilage. It can be used as the conventional sequence for the diagnosis of the articular cartilage degeneration on the knee joint.