摘要目的〓本研究旨在探讨二维快速自旋回波(two-dimensional fast spin echo,2D-FSE)序列及三维稳态采集快速成像(three-dimensional fast imaging employing steady state acquisition,3D-FIESTA)序列在前交叉韧带(anterior cruciate ligament,ACL)损伤诊断中的价值。方法〓本研究纳入2021年8月至2023年11月哈尔滨医科大学附属第一医院因膝关节损伤收治入院,并在1周内计划接受关节镜术的75例患者,其中男41例,女34例;年龄16~65岁,平均(39.02±12.32)岁。患者均接受包含3D-FIESTA序列和2D-FSE序列的MRI膝关节检查。通过关节镜术验证2D-FSE序列和3D-FIESTA序列在ACL损伤诊断中的准确性。结果〓2D-FSE序列的敏感度为90.2%,特异度为57.1%,准确性为84.0%,Kappa值为0.571,与关节镜诊断的一致性一般;同样条件下3D-FIESTA序列的敏感度为98.4%,特异度为78.6%,准确度为94.7%,Kappa值为0.846,与关节镜诊断的一致性较好。受试者工作特征曲线下面积分析显示,3D-FIESTA序列的诊断效能(0.932)明显优于2D-FSE序列(0.758)。结论〓MRI诊断ACL损伤方面,3D-FIESTA序列效果优于2D-FSE序列,结合临床查体可显著提高术前诊断的准确性,对决定是否进行手术及选择手术方法具有重要的指导意义。
[1]Wang LJ,Zeng N,Yan ZP,et al.Post-traumatic osteoarthritis following ACL injury[J].Arthritis Res Therapy,2020,22(1):57.
[2]Perry SM,McIlhenny SE,Hoffman MC,et al.Inflammatory and angiogenic mRNA levels are altered in a supraspinatus tendon overuse animal model[J].J Shoulder Ebow Surg,2005,14(1 Suppl S):79S-83S.
[3]Lefevre N,Naouri JF,Bohu Y,et al.Partial tears of the anterior cruciate ligament:Diagnostic performance of isotropic three-dimensional fast spin echo (3D-FSE-Cube) MRI[J].Eur J Orthop Surg Traumato,2014,24(1):85-91.
[4]Van Dyck P,De Smet E,Veryser J,et al.Partial tear of the anterior cruciate ligament of the knee:Injury patterns on MR imaging[J].Knee Surg,2012,20(2):256-261.
[5]李建华,宋杰,刘栋.MRI斜矢状位扫描于诊断膝关节前交叉韧带撕裂的临床价值对照分析[J].影像研究与医学应用,2021,5(3):77-78.
[6]Li B,Huang Y,Zhang Y,et al.Utilizing pre-operative MR imaging and adapting optimal needle puncture approach to improve radiofrequency ablation fraction of thoracic dorsal root ganglia[J].Sci Rep,2021,11(1):18589.
[7]Zhang Y,He X,Li J,et al.An MRI study of the tibial nerve in the ankle canal and its branches:A method of multiplanar reformation with 3D-FIESTA-C sequences[J].BMC Med Imaging,2021,21(1):51.
[8]Berthold DP,Willinger L,LeVasseur MR,et al.High rate of initially overlooked kaplan fiber complex injuries in patients with isolated anterior cruciate ligament injury[J].Am J Sports Med,2021,49(8):2117-2124.
[9]Julian M,Alexander O,Baldino BJ,et al.The ACL-deficient knee and the prevalence of meniscus and cartilage lesions:A systematic review and meta-analysis(CRD42017076897)[J].Archives Orthop Trauma Surg,2019,139(6):819-841.
[10]Hassebrock JD,Gulbrandsen MT,Asprey WL,et al.Knee ligament anatomy and biomechanics[J].Sports Med Arthroscopy Review,2020,28(3):80-86.
[11]Zhu H.Should we restart comparing clinical and MRI diagnosis of ACL tears[J].Int J Surg,2019(68):174.
[12]Wei M,Liu Y,Li Z,et al.Short-term effects of radiofrequency shrinkage treatment for anterior cruciate ligament relaxation on proprioception[J].J Int Med Res,2013,41 (5):1586-1593.
[13]Brown TR,Quinn SF,Wensel JP,et al.Diagnosis of popliteus in juries with MR imaging[J].Skeletal Radio,1995(24):511-514.
[14]张闻天,邓羽平,刘晓云,等.弹性蛋白对前交叉韧带力学响应影响的弹性蛋白酶定量分析[J].中国组织工程研究,2024,28(22):3451-3456.
[15]Morales-Avalos R,Torres-González EM,Padilla-Medina JR,et al.ACL anatomy:Is there still something to learn?[J].Rev Esp Cir Ortop Traumatol,2023:S1888-4415(23)00070-X.
[16]Zhang J,Hao D,Duan F,et al.The rotating stretched curved planar reconstruction of 3D-FIESTA MR imaging for evaluating the anterior cruciate ligament of the knee joint[J].Magnetic Resonance Imaging,2018(55):46-51.
[17]胥毅,郑洁,安超.三维稳态快速成像序列在膝关节前交叉韧带MRI检查中的应用研究[J].临床医药实践,2014,23(6):419-421.
[18]Cavinatto L,Gupta S,Morgan C,et al.Value of preoperative mri and examination under anesthesia for differentiating complete from partial anterior cruciate ligament tears[J].J Knee Surg,2019,32(7):620-623.