3.0TMRFS-PDWI和SWI诊断膝关节半月板撕裂对比研究.docVIP

3.0T MR FS-PDWI和SWI诊断膝关节半月板撕裂对比研究 张永克1，*，赵 骏1，*，王 健1，陈 伟1，杨 柳2，郭 林2，周代全1 （400038重庆，第三军医大学西南医院：放射科1，关节中心2） [摘要] 目的 比较脂肪抑制+质子加权成像序列（fat-suppression proton density weighted imaging，FS-PDWI）和磁敏感加权成像（susceptibility weighted imaging，SWI）诊断膝关节半月板撕裂的诊断效果。方法 2011年12月13日-2012年9月9日关节中心83例临床怀疑半月板损伤的患者，术前行FS-PDWI和SWI序列扫描，2名副高以上医师行影像诊断，以关节镜为金标准对照进行定性分析，并对图像质量进行半定量评分。对比FS-PDWI和SWI半月板撕裂处的信号噪声比（signal noise ratio, SNR）和与腓肠肌的对比噪声比（contrast to noise ratio, CNR）定量分析半月板撕裂处图像质量。结果 91处病变区2名医师的SWI诊断结果有极好的一致性（=0.839），综合其诊断结果得FS-PDWI诊断膝关节半月板撕裂平均的敏感性、特异性、准确性、阳性预测值和阴性预测值分别是91.5%、83.3%、90.7%、98.0%和51.7%，SWI诊断的平均敏感性、特异性、准确性、阳性预测值和阴性预测值分别是96.3%、83.3%、95.1%、98.1%和71.4%。两序列诊断半月板撕裂效果无显著性差异（P0.05）。图像半定量评分FS-PDWI和SWI无显著性差异（P0.05）。FS-PDWI和SWI的SNR和CNR分别为(26.25±6.47)和(33.94±6.41)，有显著性差异(P0.05)；CNR分别为(4.86±3.61)和(6.38±3.31)，无显著性差异(P0.05)。结论 SWI序列用于诊断膝关节半月板撕裂的诊断效果与FS-PDWI无显著性差异，敏感性、准确性和阴性检出率稍高于PDWI-FS序列，SWI有更好的SNR。 [关键词] FS-PDWI；SWI；半月板撕裂；关节镜；SNR；CNR [中图法分类号] R445 [文献标志码] A Meniscal Tear Configurations: Categorization With fat-suppression-proton density weighted imaging Compared With susceptibility weighted imaging at 3.0T Zhang Yongke1, Zhao Jun1, Wang Jian1, Chen Wei1, Yang Liu2, Guo Lin2, Zhou Daiquan1（Department of Radiology1，Centre of joint surgery2, Southwest Hospital，Third Military Medical University，Chongqing，Postcode: 400038） [Abstract] Objective To compare the effects of （fat-suppression proton density weighted imaging）FS-PDWI and SWI（susceptibility weighted imaging）in the diagnosis of meniscal tear of knee. Methods 83 patients suspected with meniscal tear were performed with 3T MRI, by the sequences of FS-PDWI and SWI before surgery. Two doctors, with sub-advanced title, qualitative diagnosed them based on the golden standard of arthroscopy. Semi-quantitative scores of all the meniscal tear images were also evaluated. The SNR (Signal Noise Ratio) in the area of meniscal tear and CNR (Contrast to noise ratio) to gastrocnemius of