Diagnostic Accuracy of a Fluid-attenuated Inversion- Recovery Sequence with Fat Suppression for Assessment of Peripatellar Synovitis: Preliminary Results and Comparison with Contrast-enhanced MR Imaging
Diagnostic Accuracy of a Fluid-attenuated Inversion- Recovery Sequence with Fat Suppression for Assessment of Peripatellar Synovitis: Preliminary Results and Comparison with Contrast-enhanced MR Imaging
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DOI：
10.1148/radiol.2016160155
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发表时间：
2017-06-01
期刊：
影响因子：
19.7
通讯作者：
Kang, Heung Sik
中科院分区：
文献类型：
--
作者：
Yoo, Hye Jin;Hong, Sung Hwan;Kang, Heung Sik
目的：确定脂肪抑制(FS)液体衰减反转恢复(FLAIR)磁共振(MR)成像和对比剂增强(CE)T1加权成像在评估膝关节周围滑膜炎中的一致性。材料和方法：机构评审委员会批准了这项回顾研究，并免除了患者知情同意的要求。对33例膝关节疼痛患者进行了3-T磁共振成像。该方案包括常规的临床序列，然后是FLAIR FS序列(反转时间，2200毫秒)和CET1加权成像。两种序列都评估了5个髌骨周围区域的滑膜可见度、滑膜厚度和滑膜炎的严重程度。并对平扫MR图像上的Hoffa滑膜炎进行分析。然后评价FLAIR FS与CET1WI之间的相关性和一致性。结果：在FLAIR FS图像上，阅读器1发现14例，阅读器2发现17例。FLAIR FS和CE T1加权成像对两种检查结果的相关性很强(相关系数为0.675~0.973)。以CET1加权像为参考标准，FLAIR FS对任何严重程度的滑膜炎均有较好的诊断效果(部位层面准确率为92.1%~93.9%，患者层面准确率为90.9%)，平扫Hoffa滑膜炎的敏感性中等(78.9%~87.5%)，特异性低(47.1%~64.3%)。两位读者在FLAIR FS和CE T1加权像上的滑膜可见度(加权k=0.81-0.88)和滑膜炎评估(组内相关系数=0.95，加权k=0.72-0.79)有很好的一致性。结论：我们的初步研究表明，FLAIR FS成像可以在不注射造影剂的情况下，以高灵敏度和高特异度评价滑膜炎症。(C)RSNA，2016年
Purpose: To determine the agreement of fat-suppressed (FS) fluid-attenuated inversion-recovery (FLAIR) magnetic resonance (MR) imaging and contrast material-enhanced (CE) T1-weighted MR imaging for the assessment of peripatellar synovitis.Materials and Methods: The institutional review board approved this retrospective study and waived the requirement for patient informed consent. Thirty-three patients with knee pain underwent 3-T MR imaging. The protocol consisted of routine clinical sequences followed by the FLAIR FS sequence (inversion time, 2200 msec) and CE T1weighted imaging. Visibility of the synovium, synovial thickness, and severity of synovitis in five peripatellar regions were assessed with both sequences. Hoffa synovitis on unenhanced MR images was also analyzed. Then, correlations and agreements between FLAIR FS and CE T1-weighted imaging were evaluated. Diagnostic performance statistics of FLAIR FS and Hoffa synovitis were calculated by using CE T1-weighted imaging as the reference standard.Results: Peripatellar synovitis on FLAIR FS images was found in 14 patients by reader 1 and in 17 patients by reader 2. Strong correlations were found between FLAIR FS and CE T1-weighted imaging in the assessment of peripatellar synovitis by both readers (correlation coefficient, 0.675-0.973). With CE T1-weighted imaging as the reference standard, FLAIR FS showed relatively good diagnostic performance for the detection of synovitis of any severity (accuracy of 92.1%-93.9% at the site level and 90.9% at the patient level), while Hoffa synovitis on unenhanced MR images showed moderate sensitivity (78.9%-87.5%) and low specificity (47.1%-64.3%) for the detection of peripatellar synovitis. There was good agreement between the two readers for the synovial visibility (weighted k = 0.81-0.88) and synovitis assessments (intraclass correlation coefficient = 0.95, weighted k = 0.72-0.79) on FLAIR FS and CE T1-weighted images.Conclusion: Our preliminary study shows that FLAIR FS imaging can potentially enable evaluation of inflamed synovium with high sensitivity and specificity, without the injection of a contrast agent. (C) RSNA, 2016