磁共振三维选择性水激发序列在膝关节软骨损伤中的应用价值

Application value of 3D-WATS magnetic resonance imaging in cartilage injury of knee joint

目的探讨三维选择性水激发序列(three dimensional water-selective excitation,3D-WATS)在膝关节软骨损伤中的应用价值。方法60例经重庆医科大学附属第二医院骨科证实膝关节软骨不同程度损伤患者,行磁共振T_(1)WI、T2WI、PDWI、T_(2)-mapping和3D-WATS成像;以关节镜检查结果为标准,PDWI、T_(2)-mapping和3D-WATS对软骨损伤的诊断效能采用卡方检验比较,分期一致性采用Spearman相关分析。结果PDWI、T2-mapping和3D-WATS 3种序列比较,对膝关节软骨损伤的诊断效能差异有统计学意义(AUC依次为0.842、0.934和0.974,P=0.000);对照关节镜结果,3D-WATS序列发现软骨损伤58例,分期与关节镜检查结果一致性较好(rho=1.00,P=0.00);T_(2)-mapping序列发现软骨损伤53例,一致性次之(rho=0.80,P=0.20);PDWI序列发现软骨损伤51例,一致性较差(rho=0.20,P=0.80),轻度损伤漏诊较多。结论3D-WATS序列对膝关节软骨损伤有较高的诊断效能及分期一致性,可作为磁共振膝关节成像的常规序列。

Objective To study the application value of magnetic resonance(MR)imaging of three dimensional water selective excitation(3D-WATS)in cartilage injury of knee joint.Methods A total of 60 patients with confirmed cartilage injury of knee joint in our hospital between January and November 2019 were recruited in this study.They all underwent MR imaging,including T_(1)WI,T_(2)WI,PDWI,T_(2)-mapping,and 3D-WATS sequences.With the results of arthroscopy as the diagnostic standard,the diagnostic efficacy of PDWI,T_(2)-mapping and 3D-WATS for cartilage injury were compared with Chi-square test,and staging coincidence was studied with Spearman correlation analysis.Results The diagnostic efficacy of PDWI,T_(2)-mapping and 3D-WATS sequences statistically differed from each other in knee cartilage injury(AUC=0.842,0.934 and 0.974;P=0.000).Compared with the results of arthroscopy,the 3D-WATS sequence revealed cartilage injury in 58 cases,and the consistency of staging was good with the results of arthroscopy(rho=1.00,P=0.00).T_(2)-mapping sequence found cartilage injury in 53 cases,and took the second in consistency of staging(rho=0.80,P=0.20).PDWI sequence revealed cartilage injury in 51 cases,with poor staging with the results of arthroscopy(rho=0.20,P=0.80),and more minor injuries were missed.Conclusion 3D-WATS sequence has good diagnostic efficacy and consistency of staging for cartilage injury,and can be used as a routine sequence of MRI knee imaging.