2D与3D MR快速自旋回波序列对膝关节交叉韧带及半月板损伤的诊断价值比较

MRI diagnosis of cruciate ligament and meniscus injuries of the knee joint:comparison between 3D with 2D turbo spin echo sequences

目的:比较三维快速自旋回波(3DSPACE)序列与传统二维快速自旋回波(2DPDWI)序列对膝关节交叉韧带和半月板损伤的诊断价值。方法:75例膝外伤患者行常规3个平面2DFS PDWI序列及3DFS PD-SPACE序列检查,检查时间分别为9分48秒和6分6秒。由2位高年资医师共同对2组图像质量进行主观评分,并在术前独立对交叉韧带和半月板的损伤情况进行评价。结果:3DFS PD-SPACE序列组的主观评分低于2DFS PDWI序列组(Z=-2.59,P<0.05)。以关节镜结果为"金标准",2DFS PDWI序列和3DFS PD-SPACE序列诊断前交叉韧带、后交叉韧带、内侧半月板和外侧半月板损伤的敏感度、特异度和准确度相近。判断前交叉韧带损伤程度方面,3DFS PD-SPACE序列与关节镜的吻合度高于2DFS PDWI序列(P<0.01)。结论:3DFS PD-SPACE序列检查效率高,诊断膝关节交叉韧带和半月板损伤的价值与常规2D序列相似,能更准确地评估前交叉韧带的损伤程度,具有潜在的临床应用价值;但需进一步优化技术以缩短单次成像时间,减少运动伪影干扰以获得更高的图像质量。

Objective：To evaluate and compare the value of 3DPD-SPACE sequence and conventional 2DPDWI sequence in diagnosing cruciate ligament and meniscus injury of the knee joint.Methods：Both 2DFS PDWI and 3DFS PDSPACE sequences of the knee joint were performed in 75 patients who suffered from knee joint trauma.The image acquisition time of the two sequence was 9min48 sand 6min6srespectively.The scores were made by two experienced radiologists subjectively to evaluate the image quality,and the injuries of the cruciate ligament and meniscus were diagnosed before surjery prospectively.Results：The score of 3DFS PD-SPACE sequence was lower than that of the 2DFS PDWI sequence（Z=-2.59,P0.05）.Taking the result of arthroscopy as gold standard,the sensitivity,specificity and accuracy of 2DFS PDWI sequence in the diagnosis of anterior and posterior cruciate ligaments as well as lateral and medial meniscus injuries were similar to that of 3DFS PD SPACE sequence.To determine the degree of the anterior cruciate ligament damage,the results of 3DFS PD-SPACE sequence was in consistent to that of arthroscopy and was higher than that of 2DFS PDWI sequence（P0.01）.Conclusion：3DFS PD-SPACE sequence had a higher operation efficacy,the value in evaluating cruciate ligament and meniscus injuries of the knee joint was similar to that of conventional 2Dsequence,more accurate evaluation of the degree of anterior cruciate ligament injury could be achieved,providing prtential clinical application value.However,further optimization of the technique is necessary in order to reduce the single examination time and motion artifact interference,then,higher image quality could be obtained.