膝关节软骨退变的MRI检查与关节镜对照研究

Articular Cartilage Degeneration of Knee Joint: A Comparison between MRI and Arthroscopy

目的 明确三维梯度回波序列与脂肪抑制技术联合应用对关节软骨退变的诊断价值 ,并用关节镜检查结果作为标准进行对照研究。资料与方法 选择 2 7例因外伤致半月板或韧带损伤需关节镜修复或关节镜下取游离体的患者作为研究对象。男 18例 ,女 9例 ,年龄 2 7～ 70岁 ,平均 5 6岁。所有病例均行膝关节MRI检查 ,检查序列包括 :SET1WI、FET2 WI、FS 3DRF spoiledFAST。MRI检查后 2周内行关节镜检查。结果 FS 3DRF spoiledFAST序列发现病变敏感性、特异性、准确性分别为 90 %、98%、96 %,病变检出率及分级与关节镜结果比较无统计学显著性差异 (P >0 .0 5 )。结论 三维梯度回波序列与脂肪抑制技术联合应用的T1WI是发现软骨退变的敏感序列。关节疼痛的患者行膝关节检查时 ,除常规MRI序列外 ,应加一软骨敏感序列。

Objective To evaluate 3-D gradient echo combined with fat-suppressed sequence imaging in diagnosing articular cartilage degeneration, to compare imaging findings with the arthroscopic results.Materials and Methods Twenty-seven patients (18 males and 9 females, ages 27～70 with a mean of 56) with traumatic injury of meniscal or cruciate ligament were enrolled in this study. MRI scanning, including SE T 1WI, FE T 2 *WI, FS 3D RF-spoiled FAST, was performed in all patients. Arthroscopy was carried out within two weeks after MRI scanning. Results The sensitivity, specificity and accuracy of FS 3D RF-spoiled FAST sequence in detecting the articular cartilage lesions were 90%, 98% and 96%, respectively. No significant difference in detecting rate and grade classification of the lesion existed between MRI and arthroscopic results (P>0.05). Conclusion T 1WI using 3-D gradient echo combined with fat-suppressed sequence is a sensitive imaging sequence for detecting articular cartilage degeneration of the knee joint. Aside from conventional MRI sequence, additional sequence sensitive for cartilage lesions should be carried out in the patients who complain of knee joint pain.