【摘要】 目的 探讨磁共振三维各向同性分辨率双回波稳态序列(three dimensional dual-echo steady state,3D-DESS)进行膝关节软骨、半月板、韧带病变诊断的有效性。方法 31例患者接受了术前3D-DESS序列扫描和膝关节镜手术治疗,由2名骨骼肌肉专业的放射科医生分别对图像进行分析,并与关节镜结果相对照。分别计算3D-DESS序列诊断2级以上软骨病变、3级以上软骨病变、半月板撕裂、韧带损伤的敏感性和特异性。观察者间的差异用Kappa值表示。结果 3D-DESS序列对2级以上软骨病变诊断敏感性和特异性:观察者A为63.95%和98.77%;观察者B为55.81%和94.44%;观察者之间Kappa值=0.77。对3级以上软骨病变诊断敏感性和特异性:观察者A为77.08%和99.00%;观察者B为68.75%和97.00%;观察者之间Kappa值=0.83。3DDESS序列对半月板撕裂诊断敏感性和特异性:观察者A为87.27%和96.18%;观察者B为69.09%和93.89%;两者之间Kappa值=0.79。对韧带损伤诊断敏感性和特异性:观察者A为100.00%和97.35%;观察者B为100.00%和92.04%;观察者之间Kappa值=0.82。结论 3D-DESS序列通过准确评价软骨病变、各向同性重建关节韧带,可作为膝关节损伤术前检查重要手段。更多还原

【Abstract】 Objective To study the usefulness of MR three dimensional double-echo steady state sequences(3D-DESS) in examining the internal derangements of the knee,including cartilage,menisci and ligaments.Methods 31 patients underwent knee MR imaging of 3D-DESS and arthroscopy.The sensitivity and specificity of 3D-DESS in detecting cartilage,meniscal and ligament injuries were calculated based on MR imaging findings which were analysed by two musculoskeletal radiologists.The analytic difference between these two radiologists was measured by Kappa value.Results The sensitivity and specificity in the detection of cartilage disorder(grade 2 or higher) were 63.95% and 98.77% for radiologist A,55.81% and 94.44% for radiologist B with kappa value of0.77;in the detection of cartilage disorder(grade 3 or higher) were 77.08% and 99.00% for radiologist A,68.75% and 97.00% for radiologist B with kappa value of 0.83;in the detection of meniscal tears were 87.27% and 96.18% for radiologist A,69.09% and93.89% for radiologist B with kappa value of 0.79;in the detection of ligament injuries were 100.00% and 97.35% for radiologist A,100.00% and 92.04% for radiologist B with kappa value of 0.82.Conclusion Because of accurate assessment of cartilage lesions and isotropic reformation of ligaments with high quality,MR 3D-DESS can be used as an important examination for the patients with knee injuries before operation.更多还原