目的探讨磁共振增强三维扰相梯度回波序列(MRI CE 3D-SPGR)对异常乙状窦的诊断价值。方法对33例搏动性耳鸣患者行MRI CE 3D-SPGR检查,并在工作站行多平面重组、曲面重组等图像后处理,观察、测量和记录异常的乙状窦影像学表现。结果 19...目的探讨磁共振增强三维扰相梯度回波序列(MRI CE 3D-SPGR)对异常乙状窦的诊断价值。方法对33例搏动性耳鸣患者行MRI CE 3D-SPGR检查,并在工作站行多平面重组、曲面重组等图像后处理,观察、测量和记录异常的乙状窦影像学表现。结果 19例均清晰显示异常的乙状窦,对应的乙状窦沟骨壁变薄,13例显示乙状窦通过骨缺损的部位突入蜂房内形成憩室,6例显示乙状窦前壁局部边缘毛糙欠光滑,呈"锯齿"状改变。结论MRI CE 3D-SPGR对异常乙状窦具有较高的诊断价值,但在显示乙状窦沟骨壁缺损方面逊色于颞骨HRCT。展开更多
Background There is a strong need for quick noninvasive diagnostic technique that can give a valid estimate of the status of the cartilage reliably, discriminating intact cartilage from various grades of impaired cart...Background There is a strong need for quick noninvasive diagnostic technique that can give a valid estimate of the status of the cartilage reliably, discriminating intact cartilage from various grades of impaired cartilage. The goal of this study was to assess the incidence of knee cartilage injuries and compare the accuracy of two-dimension spin echo （2D SE） and fast spin echo （FSE） （conventional MRI）, three-dimensional spoiled gradient echo （3D SPGR）, three-dimensional fast imaging employing steady state acquisition （3D FIESTA） MR imaging sequences with surgical examination of the articular cartilage. Methods One hundred and thirty-eight knees with history of knee trauma received conventional MRI, 3D SPGR and 3D FIESTA MRI examination before surgery, and surgical examination of articular cartilage was used as reference standard. A modified version of the Noyes classification system was applied for the evaluation of the lateral femoral condyle （LFC）, medial femoral condyle （MFC）, lateral tibial plateau （LTP）, medial tibial plateau （MTP）, trochlea and patella. The incidence and distributions of different injured grades at different articular surfaces of knee were assessed. A series of assessment indeces of 3D SPGR, 3D FIESTA, and the combination of the conventional MRI and 3D SPGR imaging were calculated. Results The incidence of cartilage defects （grade 2 to 4） was 22% （183/828）, according to surgical examination. Grade 3 and 4 lesions were absent at the medial tibial plateau. The rates of exact match between the grading results of different MRI procedures and surgical examination were 49% of 3D SPGR, 61% of 3D FIESTA, and 82% of the combination of 3D SPGR and conventional MRI. Also, the combination of 3D SPGR and conventional MR imaging provided the highest sensitivity, specificity, accuracy, positive and negative predictive values, at 71%, 97%, 90%, 90% and 90%, respectively. Conclusions For all the articular surfaces of the traumatic knees, about one fifth （22%） were cartilage defects. Both 3D SPGR and 3D FIESTA imaging performed similarly in detecting cartilage lesions of the knee. The increased accuracy in chondral assessment can be achieved by combining 3D SPGR and conventional MRI within a reasonable time.展开更多
文摘目的探讨磁共振增强三维扰相梯度回波序列(MRI CE 3D-SPGR)对异常乙状窦的诊断价值。方法对33例搏动性耳鸣患者行MRI CE 3D-SPGR检查,并在工作站行多平面重组、曲面重组等图像后处理,观察、测量和记录异常的乙状窦影像学表现。结果 19例均清晰显示异常的乙状窦,对应的乙状窦沟骨壁变薄,13例显示乙状窦通过骨缺损的部位突入蜂房内形成憩室,6例显示乙状窦前壁局部边缘毛糙欠光滑,呈"锯齿"状改变。结论MRI CE 3D-SPGR对异常乙状窦具有较高的诊断价值,但在显示乙状窦沟骨壁缺损方面逊色于颞骨HRCT。
基金This research was supported by the National Natural Science Foundation of China （No. 30670605 and No. 30870701）.
文摘Background There is a strong need for quick noninvasive diagnostic technique that can give a valid estimate of the status of the cartilage reliably, discriminating intact cartilage from various grades of impaired cartilage. The goal of this study was to assess the incidence of knee cartilage injuries and compare the accuracy of two-dimension spin echo （2D SE） and fast spin echo （FSE） （conventional MRI）, three-dimensional spoiled gradient echo （3D SPGR）, three-dimensional fast imaging employing steady state acquisition （3D FIESTA） MR imaging sequences with surgical examination of the articular cartilage. Methods One hundred and thirty-eight knees with history of knee trauma received conventional MRI, 3D SPGR and 3D FIESTA MRI examination before surgery, and surgical examination of articular cartilage was used as reference standard. A modified version of the Noyes classification system was applied for the evaluation of the lateral femoral condyle （LFC）, medial femoral condyle （MFC）, lateral tibial plateau （LTP）, medial tibial plateau （MTP）, trochlea and patella. The incidence and distributions of different injured grades at different articular surfaces of knee were assessed. A series of assessment indeces of 3D SPGR, 3D FIESTA, and the combination of the conventional MRI and 3D SPGR imaging were calculated. Results The incidence of cartilage defects （grade 2 to 4） was 22% （183/828）, according to surgical examination. Grade 3 and 4 lesions were absent at the medial tibial plateau. The rates of exact match between the grading results of different MRI procedures and surgical examination were 49% of 3D SPGR, 61% of 3D FIESTA, and 82% of the combination of 3D SPGR and conventional MRI. Also, the combination of 3D SPGR and conventional MR imaging provided the highest sensitivity, specificity, accuracy, positive and negative predictive values, at 71%, 97%, 90%, 90% and 90%, respectively. Conclusions For all the articular surfaces of the traumatic knees, about one fifth （22%） were cartilage defects. Both 3D SPGR and 3D FIESTA imaging performed similarly in detecting cartilage lesions of the knee. The increased accuracy in chondral assessment can be achieved by combining 3D SPGR and conventional MRI within a reasonable time.
