3.0-T Evaluation of Knee Cartilage by Using Three-Dimensional IDEAL GRASS Imaging: Comparison with Fast Spin-Echo Imaging
3.0-T Evaluation of Knee Cartilage by Using Three-Dimensional IDEAL GRASS Imaging: Comparison with Fast Spin-Echo Imaging
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DOI：
10.1148/radiol.09091011
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发表时间：
2010-04-01
期刊：
影响因子：
19.7
通讯作者：
Reeder, Scott B.
中科院分区：
文献类型：
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作者：
Kijowski, Richard;Blankenbaker, Donna G.;Reeder, Scott B.
目的：以关节镜为参考标准，比较稳态(GRASS)成像中水和脂肪的迭代分解、回声不对称和最小二乘估计(Idea)梯度回溯采集法与常规磁共振(MR)成像方案在评估3.0T膝关节软骨中的诊断性能。材料和方法：这项符合《健康保险携带与责任法案》的前瞻性研究是在获得机构审查委员会知情同意的情况下进行的。在95名有症状的患者(男性48名，平均年龄34.5岁；女性47名，平均年龄35.5岁)接受关节镜手术后，在常规3.0-T膝关节MR检查的基础上加入理想的GRASS。放射科医生在第一次检查时使用常规的MR方案，在第二次检查中使用理想的GRAP对每个关节表面进行分级，并确定半月板撕裂的存在。结果：以关节镜为标准，两种成像方法对软骨病变和半月板撕裂的诊断敏感性、特异性和准确性分别为68.5%、92.6%和84.5%，常规MR检查分别为66.1%、92.9%和83.9%。两种检测软骨损伤的方法在参数上没有显著差异(P=.34-.83)。对50个内侧半月板撕裂的检出参数，理想青草分别为85.0%、91.1%和87.9%，常规MR分别为94.0%、90.0%和92.1%。对31侧半月板撕裂的检出参数，理想草分别为58.0%、90.6%和80.0%，常规MR分别为80.1%、91.4%和87.9%。对于内侧半月板撕裂(P=0.04)和外侧半月板撕裂(P=0.01)，常规MR诊断半月板损伤的敏感性显著高于理想半月板损伤(P=0.01)，而对外侧半月板损伤的诊断准确性(P=0.03)显著高于理想半月板损伤(P=0.03)。结论：对于3.0T的临床患者，理想半月板损伤的诊断性能与常规MR半月板损伤检查方法相似，但其敏感性和准确性明显降低。(C)RSNA，2010年
Purpose: To compare the diagnostic performance of iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) gradient-recalled acquisition in steady-state (GRASS) imaging with a routine magnetic resonance (MR) imaging protocol for evaluating knee cartilage at 3.0 T in patients by using arthroscopy as the reference standard.Materials and Methods: This prospective Health Insurance Portability and Accountability Act-compliant study was performed with a waiver of informed consent from the institutional review board. IDEAL GRASS was added to routine 3.0-T knee MR protocol performed in 95 symptomatic patients (48 males, mean age, 34.5 years; 47 females, mean age, 35.5 years) who underwent subsequent arthroscopic surgery. Radiologists used the routine MR protocol during the first review and IDEAL GRASS during the second to grade each articular surface and to determine the presence of meniscal tears. By using arthroscopy as the reference standard, the sensitivity, specificity, and accuracy of both imaging methods for detecting cartilage lesions and meniscal tears were determined.Results: By using the z test to compare parameters between methods, the respective sensitivity, specificity, and accuracy for detecting all 192 cartilage lesions were 68.5%, 92.6%, and 84.5% for IDEAL GRASS and 66.1%, 92.9%, and 83.9% for the routine MR protocol. There was no significant difference (P = .34-.83) in parameters between methods for detecting cartilage lesions. The respective parameters for detecting 50 medial meniscal tears were 85.0%, 91.1%, and 87.9% for IDEAL GRASS and 94.0%, 90.0%, and 92.1% for the routine MR protocol. The parameters for detecting 31 lateral meniscal tears were 58.0%, 90.6%, and 80.0% for IDEAL GRASS and 80.1%, 91.4%, and 87.9% for the routine MR protocol. The routine MR protocol had a significantly higher sensitivity for detecting medial meniscal tears (P = .04) and lateral meniscal tears (P = .01) and significantly higher accuracy for detecting lateral meniscal tears (P = .03) than IDEAL GRASS.Conclusion: IDEAL GRASS has similar diagnostic performance as routine MR protocol for evaluating the articular cartilage of the knee in clinical patients at 3.0 T but has significantly lower sensitivity and accuracy for detecting meniscal tears. (C) RSNA, 2010