磁共振不同序列在KOA关节软骨损伤中的诊断价值及临床意义

The Diagnostic Value and Clinical Significance of Different Sequences of Magnetic Resonance in KOA Articular Cartilage Injury

目的:评价磁共振不同序列在膝骨性关节炎(KOA)关节软骨损伤中的诊断价值及临床意义。方法:选取2018年1月-2021年2月上海建工医院收治的疑似KOA患者136例,对患者分别采取T_(1)加权成像矢状位(T_(1)-SE-SAG)序列、T_(2)加权像成像横断位(T_(2)-TSE-TRA)序列、质子密度加权像矢状位(PD-TSE-SAG)序列以及质子密度加权像冠状位(PD-TSE-COR)序列进行检查,并以关节镜检查结果为金标准,评价分析磁共振不同序列对KOA关节软骨损伤的诊断情况。结果:T_(1)-SE-SAG序列对Ⅰ~Ⅳ级关节软骨损伤的敏感度分别为52.17%、64.52%、78.38%、82.61%;T_(2)-TSE-TRA序列对Ⅰ~Ⅳ级关节软骨损伤的敏感度分别为67.39%、77.42%、81.08%、82.61%;PD-TSE-SAG序列对Ⅰ~Ⅳ级关节软骨损伤的敏感度分别为82.61%、87.10%、91.89%、95.65%;PD-TSE-COR序列对Ⅰ~Ⅳ级关节软骨损伤的敏感度分别为86.96%、87.10%、89.19%、95.65%。与T_(1)-SE-SAG序列比较,PD-TSE-SAG序列和PD-TSE-COR序列的敏感度以及准确度均较高,差异均有统计学意义(P<0.05);与T_(2)-TSE-TRA序列比较,PD-TSE-SAG序列的敏感度、特异度以及准确度均较高,而PD-TSE-COR序列的敏感度和准确度亦均高于T_(2)-TSE-TRA序列,差异均有统计学意义(P<0.05)。结论:PD-TSE-SAG序列和PD-TSE-COR序列对KOA关节软骨损伤的诊断分级更为准确,且诊断效能较高,具有较高的临床应用价值。

Objective:To evaluate the diagnostic value and clinical significance of different sequences of magnetic resonance in KOA articular cartilage injury.Method:A total of 136 suspected KOA patients who were admitted to Shanghai Construction Engineering Hospital from January 2018 to February 2021 were selected.T_(1) weighted imaging sagittal (T_(1)-SE-SAG) sequence and T_(2)-weighted imaging transverse position (T_(2)-TSE-TRA) sequence,proton density weighted image sagittal (PD-TSE-SAG) sequence and proton density weighted image coronal (PD-TSE-COR) sequence for inspection,the results of arthroscopy were used as the gold standard to evaluate and analyze the diagnosis of KOA articular cartilage injury with different MRI sequences.Result:The sensitivity of T_(1)-SE-SAG sequence for grade Ⅰ-Ⅳ articular cartilage damage were 52.17%,64.52%,78.38%,and 82.61%,respectively;the sensitivity of T_(2)-TSE-TRA sequence for grade Ⅰ-Ⅳ articular cartilage damage were 67.39%,77.42%,81.08%,82.61%;the sensitivity of PD-TSE-SAG sequence for grade I to IV articular cartilage injury were 82.61%,87.10%,91.89%,95.65%,respectively;the sensitivity of PD-TSE-COR sequence for grade Ⅰ-Ⅳ articular cartilage injury were 86.96%,87.10%,89.19%,95.65%,respectively.Compared with the T_(1)-SE-SAG sequence,the sensitivity and accuracy of the PD-TSE-SAG sequence and the PD-TSE-COR sequence were higher,the differences were statistically significant (P<0.05);compared with T_(2)-TSE-TRA sequence comparison,PD-TSE-SAG sequence had higher sensitivity,specificity and accuracy,and PD-TSE-COR sequence had higher sensitivity and accuracy than T_(2)-TSE-TRA sequence,the differences were statistically significant (P<0.05).Conclusion:The PD-TSE-SAG sequence and PD-TSE-COR sequence are more accurate in the diagnosis of KOA articular cartilage injury,and have higher diagnostic efficiency,which has higher clinical application value.