3.0T MRI 3D-FS-FLASH、T2-mapping较常规序列诊断膝关节软骨早期损伤优势分析

Advantages of 3.0T MRI 3D-FS-FLASH and T2-mapping in the early diagnosis of knee joint cartilage compared with conventional sequence

目的:探讨3.0T MRI 3D-FS-FLASH(三维抑脂快速扰相梯度回波序列)、T2-mapping序列与常规序列相比,在诊断膝关节软骨早期损伤方面的优势。方法:选取外伤或骨关节炎前来就诊的患者为研究对象。从其中筛选出先行MRI检查,之后一周内行关节镜微创手术的患者共56例。记录三种磁共振序列下膝关节6处关节软骨损伤的分级。然后以关节镜为金标准,计算三者的敏感度和特异度,再进行统计学分析。结果:三种磁共振序列诊断膝关节软骨Ⅰ、Ⅱ级损伤的敏感度差别具有统计学意义(P<0.05)。两两比较发现,3D-FS-FLASH序列诊断膝关节软骨Ⅰ级损伤的敏感度高于T2-mapping序列(P<0.0125)。结论:3D-FS-FLASH诊断软骨损伤的敏感度最高。常规序列的特异度最高。3D-FS-FLASH是目前诊断膝关节软骨损伤的最优序列,可作为常规序列应用于膝关节软骨早期损伤的诊断。

Objective:To investigate the advantages of 3.0 T MRI 3 D-FS-FLASH(three dimensional lipid suppression fast disturbing gradient echo sequence) and T2-mapping sequence in the diagnosis of early injury of knee cartilage compared with conventional sequence.Methods:Patients with knee joint trauma or osteoarthritis were selected as subjects.A total of 56 patients underment arthroscopic minimally invasive surgery within one week after screening out for MRI.The grades of 6 articular cartilage injuries of knee joint under three magnetic resonance sequences were recorded.Then the sensitivity and specificity of the three were calculated with arthroscopy as the gold standard,and then the statistical analysis was carried out.Results:The sensitivity difference of three kinds of magnetic resonance sequences in the diagnosis of knee cartilage Ⅰ,Ⅱ grade injury was statistically significant(P<0.05).The sensitivity of 3 D-FS-FLASH sequence in diagnosis of knee cartilage level Ⅰ injury was higher than that of T2-mapping sequence(P<0.0125).Conclusion:3 D-FS-FLASH has the highest sensitivity in the diagnosis of cartilage injury.The specificity of conventional sequence is the highest.3 D-FS-FLASH is the best sequence for the diagnosis of knee cartilage injury at present,which can be used as routine sequence in the diagnosis of early knee cartilage injury.