磁共振FLAIR-FS序列成像在早期膝关节滑膜炎诊断中的应用价值

Application of magnetic resonance imaging FLAIR-FS in the diagnosis of early knee synovitis

目的分析磁共振(MRI)脂肪抑制液体衰减反转恢复(FLAIR-FS)序列成像在早期膝关节滑膜炎(KS)诊断中的应用价值。方法回顾性抽取2020年1月至2021年5月南阳市中心医院收治的早期KS患者126例,均行MRI FLAIR-FS序列和脂肪抑制质子密度加权(PDWI-FS)序列扫描。比较两种检查序列滑膜评分诊断情况和一致性、滑膜厚度与FLAIR-FS评分的相关性、FLAIR-FS序列滑膜分级和厚度测量的可重复评估性。结果PDWI-FS序列滑膜评分以1~2分为主,FLAIR-FS序列滑膜评分以2~3分为主。Kappa检验结果显示,两种序列检查方法对滑膜评分加权Kappa值经比较差异有统计学意义(Kappa=0.184,95%CI为0.079~0.288,P=0.01)。FLAIR-FS评分3分者滑膜厚度高于1分者和2分者,差异有统计学意义(F=1996.78,P<0.05)。Pearson结果显示,FLAIR-FS评分与滑膜厚度呈正相关(R=0.66,P<0.05)。FLAIR-FS序列2次滑膜分级评估的一致性一般(Kappa=0.375),滑膜厚度测量相关系数为0.974,95%CI为0.942~0.996。结论MRI FLAIR-FS序列成像应用于早期KS诊断中,可有效测定滑膜厚度、滑膜评分,为临床诊断提供影像信息支持。

Objective To analyze the application of magnetic resonance imaging(MRI)fluid-attenuated inversion recovery sequence with fat suppression(FLAIR-FS)in the diagnosis of early knee synovitis(KS).Methods A total of 126 patients with early KS admitted to Nanyang Central Hospital from January 2020 to May 2021 were retrospectively selected,and all of them underwent MRI FLAIR-FS and proton density-weighted imaging fat-saturated(PDWI-FS)examination.The diagnosis and consistency of synovial scores between the two examination methods were compared.The correlation between synovial thickness and FLAIR-FS score was analyzed,and the reproducible evaluation of FLAIR-FS in synovial grading and thickness measurement was analyzed.Results The synovial score assessed by PDWI-FS in the 126 patients were mainly 1-2,and the synovial score assessed by FLAIR-FS were mainly 2-3.Results of Kappa test showed that there was a statistically significant difference between the two sequence examination methods in the weighted Kappa value of synovial score(Kappa=0.184,95%CI 0.079-0.288,P=0.01).The synovial thickness of patients with FLAIR-FS score 3 was thicker than that of patient with FLAIR-FS score 1 and 2(F=1996.78,P<0.05).The results of Pearson analysis showed that FLAIR-FS score was positively correlated with synovial thickness(R=0.66,P<0.05).The consistency of the two synovial grading evaluated by FLAIR-FS sequence was general(Kappa=0.375),and the correlation coefficient of synovial thickness was 0.974,and the 95%CI was 0.942-0.996.Conclusions MRI FLAIR-FS can effectively measure synovial thickness and synovial score in the diagnosis of early KS,and provide image information for clinical diagnosis.