3.0T磁共振诊断膝关节半月板损伤与关节镜的一致性研究

Agreement of 3.0T Magnetic Resonance in the Diagnosis of Knee Meniscus Injury and Arthroscopy

目的分析3.0T磁共振(MRI)二维快速自旋回波(2D-FSE)、三维快速自旋回波(3D-S PACE)诊断膝关节半月板损伤与关节镜的一致性。方法选定上海市第四人民医院2020年10月至2022年10月接诊的64例膝关节半月板损伤患者,均给予MRI检查,分别进行2D-FSE、3D-SPACE扫描,将关节镜作为膝关节半月板损伤的诊断“金标准”,比较2D-FSE、3D-SPACE诊断准确率、灵敏度及特异度,Kappa检验2D-FSE、3D-SPACE与金标准的一致性,比较2D-FSE、3D-SPACE扫描下半月板组织对比噪声比(CNR)。结果3D-SPACE诊断准确率(95,31%)、灵敏度(96.55%)均高于2D-FSE(78.13%、79.31%),P<0.05;3D-SPACE诊断特异度(83.33%)与2D-FSE比较,P>0.05;Kappa检验2D-FSE与关节镜一致性一般(Kap pa值=0.586),P<0.05;3D-SPACE与关节镜一致性较好(Kappa值=0.792),P<0.05。3D-SPACE扫描下半月板与关节液、半月板与软骨CNR与2D-FSE比较,P>0.05;3D-SPACE扫描下半月板与韧带CNR高于2D-FSE,P<0.05。结论3D-SPACE在膝关节半月板损伤诊断中的准确率、灵敏度均较高,可准确评估半月板与韧带损伤程度,图像质量更高,具有一定的参考价值。

Objective To analyze the consistency of 3.0T magnetic resonance imaging(MRI)2D rapid spin echo(2D-FSE)and 3D rapid spin echo(3D-SPACE)in the diagnosis of knee meniscus injury and arthroscopy.Methods A total of 64 patients with knee meniscus injury received in Shanghai Fourth People's Hospital from October 2020 to October 2022 were selected to receive MRI examination,2D-FSE and 3D-SPACE scanning,respectively.Arthroscopy was used as the gold standard for the diagnosis of knee meniscus injury.The diagnostic accuracy,sensitivity and specificity of 2D-FSE and 3D-SPACE were compared.The consistency of 2D-FSE and 3D-SPACE with gold standard was tested by Kappa,and the contrastive noise ratio(CNR)of meniscus tissue under 2D-FSE and 3D-SPACE scanning was compared.Results The diagnostic accuracy(95.31%)and sensitivity(96.55%)of 3D-SPACE were higher than those of 2D-FSE(78.13%and 79.31%),P<0.05.The diagnostic specificity of 3D-SPACE(83.33%)was higher than that of 2D-FSE(P>0.05).Kappa test showed general consistency between 2D-FSE and arthroscopy(Kappa value=0.586),P<0.05,and good consistency between 3D-SPACE and arthroscopy(Kappa value=0.792),P<0.05.Comparison of meniscus and articular fluid,meniscus and cartilage CNR and 2D-FSE in 3D-SPACE scanning(P>0.05);The CNR of meniscus and ligament in 3D-SPACE scan was higher than that in 2D-FSE,P<0.05.Conclusion The accuracy and sensitivity of 3D-SPACE in the diagnosis of knee meniscus injury are both high,which can accurately evaluate the degree of meniscus and ligament injury,and the image quality is higher,which has certain reference value.