Comprehensive Assessment of Ankle Syndesmosis Injury Using 3D Isotropic Turbo Spin-Echo Sequences: Diagnostic Performance Compared With That of Conventional and Oblique 3-T MRI
Comprehensive Assessment of Ankle Syndesmosis Injury Using 3D Isotropic Turbo Spin-Echo Sequences: Diagnostic Performance Compared With That of Conventional and Oblique 3-T MRI
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DOI：
10.2214/ajr.16.16985
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发表时间：
2017-04-01
影响因子：
5
通讯作者：
Young, Ki Won
中科院分区：
文献类型：
--
作者：
Kim, Minchul;Choi, Yun Sun;Young, Ki Won
OBJECTIVE.本研究的目的是评估3D采样完美的诊断性能与应用程序优化的对比使用不同的翻转角演变（SPACE）序列在踝关节韧带联合损伤的评价，与传统的正交MRI和斜质子密度加权快速自旋回波（TSE）序列进行了3-TMRIS.MATERIALS和METHODS。这项回顾性研究包括98例疑似踝关节韧带联合损伤的患者，他们接受了MRI和手术。50名患者（平均[+/- SD]年龄，34.5 +/- 15.3岁）有急性损伤，48名患者（平均年龄，28.5 +/- 9.6岁）有慢性损伤。对于两组，评价了每个MRI序列对下胫腓联合损伤的诊断性能。关节镜检查结果被用作确认诊断的参考标准。质子密度加权TSE序列和3D SPACE序列在敏感性、特异性、准确性和AUC值方面无统计学显著性差异（p > 0.05）。对于急性和慢性联合韧带损伤的诊断，观察者之间的一致性在质子密度加权TSE图像上几乎是完美的（kappa > 0.80），在3D SPACE图像上是实质性的（kappa > 0.75）。两种方法对下胫腓联合的诊断均上级常规正交MRI。3D SPACE序列在诊断急性和慢性韧带联合损伤方面的性能与2D质子密度加权MR图像相当。
OBJECTIVE. The objective of this study is to evaluate the diagnostic performance of 3D sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) sequences in the evaluation of ankle syndesmosis injuries, compared with that of conventional orthogonal MRI and oblique proton density-weighted turbo spin-echo (TSE) sequences performed with 3-T MRI.MATERIALS AND METHODS. This retrospective study included 98 patients with suspected ankle syndesmosis injuries who underwent both MRI and surgery. Fifty patients (mean [+/- SD] age, 34.5 +/- 15.3 years) had acute injuries, and 48 patients (mean age, 28.5 +/- 9.6 years) had chronic injuries. For both groups, the diagnostic performance of each MRI sequence with regard to syndesmosis injuries was evaluated. Arthroscopy findings were used as a reference standard to confirm diagnosis.RESULTS. No statistically significant differences in the sensitivity, specificity, accuracy, and AUC values were noted between images of the syndesmosis obtained using proton density-weighted TSE sequences and images of the syndesmosis obtained using 3D SPACE sequences (p > 0.05). Interobserver agreement regarding the diagnosis of both acute and chronic syndesmosis injuries was almost perfect for proton density-weighted TSE images (kappa > 0.80) and was substantial for 3D SPACE images (kappa > 0.75). Both methods of obtaining images of the syndesmosis had a diagnostic performance superior to that of conventional orthogonal MRI.CONCLUSION. The performance of 3D SPACE sequences is comparable to that of 2D proton density-weighted MR images for the diagnosis of acute and chronic syndesmosis injuries.