DETECTION OF KNEE HYALINE CARTILAGE DEFECTS USING FAT-SUPPRESSED 3-DIMENSIONAL SPOILED GRADIENT-ECHO MR-IMAGING - COMPARISON WITH STANDARD MR-IMAGING AND CORRELATION WITH ARTHROSCOPY
DETECTION OF KNEE HYALINE CARTILAGE DEFECTS USING FAT-SUPPRESSED 3-DIMENSIONAL SPOILED GRADIENT-ECHO MR-IMAGING - COMPARISON WITH STANDARD MR-IMAGING AND CORRELATION WITH ARTHROSCOPY
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DOI：
10.2214/ajr.165.2.7618561
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发表时间：
1995-08-01
影响因子：
5
通讯作者：
FUCHS, MD
中科院分区：
文献类型：
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作者：
DISLER, DG;MCCAULEY, TR;FUCHS, MD
objective.进行了一项初步研究，前瞻性地比较脂肪抑制三维扰相梯度回波（3D SPGR）MR成像与标准MR成像检测膝关节透明软骨缺损，使用关节镜检查作为参考标准。我们研究了43名连续患者，由两位骨科医生转诊进行膝关节MR成像，12名患者具有关节镜相关性;他们构成了我们研究的基础，透明软骨采用脂肪抑制3D SPGR序列成像，采用先前确定的最佳成像参数。我们的标准MR成像研究包括二维冠状面T1加权自旋回波、矢状面双回波TS加权自旋回波和轴向多平面梯度回波序列。以关节镜检查为参考标准，通过关节面（每个患者8个表面：内侧和外侧髌骨小面、股骨小面、股骨髁和胫骨平台）确定脂肪抑制的3D SPGR和标准MR图像检测软骨撕裂的敏感性和特异性，确定敏感性和特异性的统计学显著差异。关节镜检查显示7例患者15处软骨缺损。脂肪抑制3D SPGR图像的敏感性（93%）高于标准MR图像（53%，p = 0.03），脂肪抑制3D SPGR图像的特异性为94%，而标准MR图像为93%（p> 0.05）。脂肪抑制3D SPGR图像上的5个假阳性关节面来自软骨实质内的局灶性信号变化，没有轮廓缺陷。所有受试者股骨外侧切迹处透明软骨的平滑轮廓变薄和三层外观丢失，被认为是正常的发现。脂肪抑制3DSPGR成像对膝关节透明软骨异常的检测比标准MR成像更敏感，常规使用该技术可加强MR成像对膝关节内部紊乱的无创评估作用。
OBJECTIVE. A preliminary study was done to prospectively compare fat-suppressed three-dimensional spoiled gradient-echo (3D SPGR) MR imaging with standard MR imaging for detection of defects in the hyaline cartilage of the knee, using arthroscopy as the reference standard.SUBJECTS AND METHODS. We studied 43 consecutive patients referred by two orthopedic surgeons for MR imaging of the knee, Twelve had arthroscopic correlation; they formed the basis of our study, Hyaline cartilage was imaged with a fat-suppressed 3D SPGR sequence with previously determined optimal imaging parameters. Our standard MR imaging study consisted of two-dimensional coronal T1-weighted spin-echo, sagittal dual-echo TS-weighted spin-echo, and axial multiplanar gradient-echo sequences. With arthroscopy as the reference standard, sensitivity and specificity of fat-suppressed 3D SPGR and standard MR images for detecting cartilage tears were determined by articular surface (eight surfaces in each patient: medial and lateral patellar facets, trochlear facets, femoral condyles, and tibial plateaus), Statistically significant differences in sensitivity and specificity were determined.RESULTS. Arthroscopy showed 15 cartilage defects in seven patients. The fat-suppressed 3D SPGR images had higher sensitivity (93%) than the standard MR images (53%, p=.03), Specificity was 94% for the fat-suppressed 3D SPGR images compared with 93% for the standard MR images (p>.05). The five false-positive articular surfaces on fat-suppressed 3D SPGR images were from focal signal change within the substance of the cartilage without a contour defect. Smoothly contoured thinning and loss of the trilaminar appearance of the hyaline cartilage at the lateral femoral notch was shown in all subjects and was considered a normal finding.CONCLUSION. Fat-suppressed 3D SPGR imaging is more sensitive than standard MR imaging for the detection of abnormalities of the hyaline cartilage in the knee, Routine use of this technique may strengthen the role of MR imaging for noninvasive evaluation of internal derangements of the knee.