Evaluation of the Articular Cartilage of the Knee Joint: Value of Adding a T2 Mapping Sequence to a Routine MR Imaging Protocol
Evaluation of the Articular Cartilage of the Knee Joint: Value of Adding a T2 Mapping Sequence to a Routine MR Imaging Protocol
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DOI：
10.1148/radiol.12121413
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发表时间：
2013-05-01
期刊：
影响因子：
19.7
通讯作者：
Graf, Ben K.
中科院分区：
文献类型：
--
作者：
Kijowski, Richard;Blankenbaker, Donna G.;Graf, Ben K.
目的：为了确定是否增加T2映射序列的常规磁共振（MR）成像协议可以提高诊断性能在膝关节内的手术证实的软骨病变的检测在3.0 T材料和方法：这项前瞻性研究的机构审查委员会批准，并要求获得知情同意书被免除。研究组包括150名患者（76名男性和74名女性患者，平均年龄分别为41.2岁和41.5岁），他们接受了膝关节的MR成像和关节镜检查。在3.0 T下通过使用常规方案并添加矢状T2标测序列进行MR成像。术前由两名放射科医生一致审查所有MR检查的图像，以确定每个关节面上是否存在软骨病变，首先单独使用常规MR方案，然后使用常规MR方案和T2图。然后在关节镜下对每个关节面进行评价。广义估计方程模型被用来比较常规MR成像协议的敏感性和特异性与不T2地图在检测手术证实的软骨病变。对351例软骨病变的诊断敏感性和特异性分别为74.6%和97.8%，对于常规MR方案，T2标测图为88.9%和93.1%。敏感性和特异性差异有统计学意义（P < .001）。在常规MR成像方案中增加T2图显著提高了检测24个软骨软化区域的灵敏度（从4.2%到62%，P < .001），41个软骨纤维化区域（从20%到66%，P < .001），和96个表浅部分厚度软骨缺损（从71%到88%，P = .004）。在3.0 T常规MR方案中增加T2标测序列可提高膝关节内软骨病变检测的灵敏度从74.6%下降到88.9%，特异性略有下降。使用T2图的灵敏度的最大改善是早期软骨退变的识别。(C)RSNA，2013年
Purpose: To determine whether the addition of a T2 mapping sequence to a routine magnetic resonance (MR) imaging protocol could improve diagnostic performance in the detection of surgically confirmed cartilage lesions within the knee joint at 3.0 T.Materials and Methods: This prospective study was approved by the institutional review board, and the requirement to obtain informed consent was waived. The study group consisted of 150 patients (76 male and 74 female patients with an average age of 41.2 and 41.5 years, respectively) who underwent MR imaging and arthroscopy of the knee joint. MR imaging was performed at 3.0 T by using a routine protocol with the addition of a sagittal T2 mapping sequence. Images from all MR examinations were reviewed in consensus by two radiologists before surgery to determine the presence or absence of cartilage lesions on each articular surface, first by using the routine MR protocol alone and then by using the routine MR protocol with T2 maps. Each articular surface was then evaluated at arthroscopy. Generalized estimating equation models were used to compare the sensitivity and specificity of the routine MR imaging protocol with and without T2 maps in the detection of surgically confirmed cartilage lesions.Results: The sensitivity and specificity in the detection of 351 cartilage lesions were 74.6% and 97.8%, respectively, for the routine MR protocol alone and 88.9% and 93.1% for the routine MR protocol with T2 maps. Differences in sensitivity and specificity were statistically significant (P < .001). The addition of T2 maps to the routine MR imaging protocol significantly improved the sensitivity in the detection of 24 areas of cartilage softening (from 4.2% to 62%, P < .001), 41 areas of cartilage fibrillation (from 20% to 66%, P < .001), and 96 superficial partial-thickness cartilage defects (from 71% to 88%, P = .004).Conclusion: The addition of a T2 mapping sequence to a routine MR protocol at 3.0 T improved sensitivity in the detection of cartilage lesions within the knee joint from 74.6% to 88.9%, with only a small reduction in specificity. The greatest improvement in sensitivity with use of the T2 maps was in the identification of early cartilage degeneration. (C) RSNA, 2013