Diagnosis of Internal Derangement of the Knee at 3.0-T MR Imaging: 3D Isotropic Intermediate-weighted versus 2D Sequences
Diagnosis of Internal Derangement of the Knee at 3.0-T MR Imaging: 3D Isotropic Intermediate-weighted versus 2D Sequences
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DOI：
10.1148/radiol.2533090457
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发表时间：
2009-12-01
期刊：
影响因子：
19.7
通讯作者：
Choe, Bong-Keun
中科院分区：
文献类型：
--
作者：
Jung, Jee Young;Yoon, Young Cheol;Choe, Bong-Keun
目的：比较三维 (3D) 各向同性快速自旋回波 (SE) 中加权磁共振 (MR) 成像与二维 (2D) 快速 SE MR 成像（两者均在 3.0 T 下进行）在诊断膝关节内部紊乱方面的性能。 材料和方法：机构审查委员会批准了这项符合 HIPAA 的研究，并免除了知情同意的要求。作者回顾性回顾了 85 名患者获得的 87 幅膝关节 MR 图像，这些患者接受了 3.0 T 膝关节 3D 各向同性和 2D MR 检查以及随后的关节镜手术。 2D MR 图像包括中等加权的冠状和矢状图像、具有脂肪饱和度的中等加权轴向图像和 T2 加权矢状图像。 3D 各向同性 MR 图像是通过多平面重组 (MPR)、快速 SE 中间加权序列和 0.5 x 0.5 x 0.5 mm 的重建体素尺寸获得的。两名放射科医生在不同的疗程中回顾性地独立评估了 2D 和 3D 数据集，以确定是否存在内侧半月板 (MM)、外侧半月板 (LM)、前十字韧带 (ACL) 和后十字韧带 (PCL) 撕裂。将这些解释与关节镜手术的结果进行比较。两种方法的敏感性、特异性和准确性之间的统计差异通过 McNemar 测试确定，并以手术结果作为参考标准。使用 kappa 系数计算观察者间一致性。结果：对于两位评价者，两种 MR 技术诊断 ACL 和 PCL 撕裂的敏感性、特异性和准确性均高于 95%，诊断 MM 撕裂的敏感性、特异性和准确性高于 85%，诊断 LM 撕裂的敏感性、特异性和准确性高于 80%。两种方法之间的敏感性、特异性或准确性没有显着差异。所有病变评估的观察者间一致性非常好，范围从 0.81（使用 3D 和 2D 序列评估 LM 撕裂）到 0.93（使用 3D 和 2D 序列评估 ACL 撕裂、使用 2D 序列评估 PCL 撕裂、使用 3D 序列评估 MM 撕裂）。结论：MPR 的 3D 各向同性快速 SE 中间加权 MR 成像在诊断中的性能与 2D MR 成像的性能没有显着差异膝盖十字韧带和半月板撕裂。 (C) 北美放射学会，2009
Purpose: To compare three-dimensional (3D) isotropic fast spin-echo (SE) intermediate-weighted magnetic resonance (MR) imaging with two-dimensional (2D) fast SE MR imaging-both performed at 3.0 T-for performance in the diagnosis of internal derangements of the knee.Materials and Methods: The institutional review board approved this HIPAA-compliant study, and the requirement for informed consent was waived. The authors retrospectively reviewed 87 knee MR images obtained in 85 patients who had undergone both 3D isotropic and 2D MR examinations of the knee at 3.0 T and subsequent arthroscopic surgery. The 2D MR images included intermediate-weighted coronal and sagittal images, intermediate-weighted axial images with fat saturation, and T2-weighted sagittal images. The 3D isotropic MR images were obtained with multiplanar reformation (MPR), a fast SE intermediate-weighted sequence, and a reconstruction voxel size of 0.5 x 0.5 x 0.5 mm. Two radiologists retrospectively and independently evaluated the 2D and 3D data sets, at different sessions, for the presence of medial meniscus (MM), lateral meniscus (LM), anterior cruciate ligament (ACL), and posterior cruciate ligament (PCL) tears. These interpretations were compared with the arthroscopic surgery findings. The statistical differences between the sensitivities, specificities, and accuracies of the two methods were determined at McNemar testing, with surgical findings serving as the reference standard. Interobserver agreement was calculated by using kappa coefficients.Results: For both reviewers, the sensitivity, specificity, and accuracy of both MR techniques were higher than 95% for the diagnosis of ACL and PCL tears, higher than 85% for the diagnosis of MM tears, and higher than 80% for the diagnosis of LM tears. There were no significant differences in sensitivity, specificity, or accuracy between the two methods. Interobserver agreement for evaluation of all lesions was excellent and ranged from 0.81 (LM tears evaluated with 3D and 2D sequences) to 0.93 (ACL tears evaluated with 3D and 2D sequences, PCL tears evaluated with 2D sequence, and MM tears evaluated with 3D sequence).Conclusion: The performance of 3D isotropic fast SE intermediate-weighted MR imaging with MPR was not significantly different from that of 2D MR imaging in the diagnosis of cruciate ligament and meniscal tears of the knee. (C) RSNA, 2009