3.0T MRI 3D-MERGE序列在评价冈上肌肌腱损伤程度中的应用价值
收稿日期: 2020-08-20
网络出版日期: 2022-06-28
基金资助
昆山高层次医学人才柔性引进团队项目(01201802)
Application value of 3.0T MRI 3D-MERGE sequence in evaluating the degree of supraspinatus tendon injury
Received date: 2020-08-20
Online published: 2022-06-28
目的:探讨3.0T MRI三维-多回波恢复梯度回波(3 dimensional-multiple-echo recalled gradient echo, 3D-MERGE)序列在评价冈上肌肌腱损伤程度中的应用价值。方法:回顾性分析经关节镜证实的52例肩痛患者的3.0T MRI 3D-MERGE序列和常规序列[包括斜冠状位T1加权成像(T1 weighted image,T1WI)、T2WI-脂肪抑制(fat suppress,FS)、轴位T2WI-FS和斜矢状位质子密度加权成像(proton density weighted imaging,PDWI)-FS]影像资料,以关节镜检查结果为标准,分为Ⅰ组(冈上肌肌腱无损伤,含变性)、Ⅱ组(冈上肌肌腱轻度损伤,即撕裂<50%)、Ⅲ组(冈上肌肌腱中重度损伤,撕裂≥50%,但未完全撕裂)和Ⅳ组(冈上肌肌腱重度损伤,完全撕裂),观察各组间的3D-MERGE序列、常规序列及联合以上2种序列的扫描结果,并比较3种MRI检查方法诊断冈上肌肌腱损伤程度的灵敏度、特异度、阳性预测值、阴性预测值。结果:3D-MERGE序列、常规序列及2种序列联合检查判别冈上肌肌腱轻度及以下损伤(Ⅰ组+Ⅱ组)的诊断效能间差异无统计学意义(P均>0.05)。判别冈上肌肌腱中重度及以上损伤(Ⅲ组+Ⅳ组)时,3D-MERGE序列、常规序列及2种序列联合检查的灵敏度、特异度、阳性预测值、阴性预测值分别为100%、80.00%、88.90%、100%,65.60%、100%、100%、64.50%,100%、90.00%、94.10%、100%。3D-MERGE序列检查及2种序列联合检查的诊断效能均优于常规序列(P均<0.05),而3D-MERGE序列与2种序列联合检查的诊断效能间差异无统计学意义(P=0.38)。结论:与常规序列相比,MRI 3D-MERGE序列检查在诊断冈上肌肌腱中重度及以上损伤时效能较高,可作为评价冈上肌肌腱损伤程度的补充序列。
关键词: 磁共振; 三维-多回波恢复梯度回波序列; 冈上肌肌腱损伤
曹俊涛, 胡铭, 钱平康, 屠建春, 张欢, 沈钧康 . 3.0T MRI 3D-MERGE序列在评价冈上肌肌腱损伤程度中的应用价值[J]. 诊断学理论与实践, 2021 , 20(01) : 77 -81 . DOI: 10.16150/j.1671-2870.2021.01.012
Objective: To study the application value of 3.0T MRI 3D-MERGE sequence in evaluating the degree of supraspinatus tendon injury. Methods: A total of 52 patients with shoulder pain diagnosed with arthroscopy were enrolled. The 3.0T MRI 3D-MERGE sequence and conventional sequences (including T1WI, T2WI-FS, T2WI-FS on axial plane and PDWI-FS on oblique sagittal plane) were performed, and the results were retrospectively analyzed. According to the arthroscopic findings, the patients were divided into 4 groups: group Ⅰ(without supraspinatus tendon injury), group Ⅱ(mild tear of supraspinatus tendon, <50%), group Ⅲ (moderate to severe tear of supraspinatus tendon, ≥50% but not completely) and group Ⅳ(supraspinatus tendon tear completely). The diagnostic efficacy of 3D-MERGE sequence, conventional sequences alone and combination for supraspinatus tendon injury were compared. Results: The diagnostic efficacy between 3D-MERGE sequence, conventional sequences alone and combination for differentiating supraspinatus tendon with tear from without tear were similar (all P values>0.05). The sensitivity,specificity,positive predictive value,negative predictive value of the 3D-MERGE sequence, the conventional sequences and the combined two sequences were 100%, 80.00%, 88.90%, 100%, and 65.60%, 100%, 100%, 64.50%, and 100%, 90.00%, 94.10%, 100%, respectively. However, for evaluating supraspinatus tendon tear≥50% and above, the diagnostic efficacies of the 3D-MERGE sequence and the combined two sequences were better than that of conventional sequences (both P values<0.05). There was no significant difference between the 3D-MERGE sequence and the combined two sequences (P=0.38). Conclusions: Compared with conventional sequences, 3D-MERGE sequence has a higher performance for diagnosing supraspinatus tendon injury from moderate to severe degree or above, and it could be used as a supplementary sequence for evaluating the degree of supraspinatus tendon injury.
[1] | Graham P. Rotator cuff tear[J]. Orthop Nurs, 2018, 37(2):154-156. |
[2] | Godley C, Funk L. Arthroscopic repair of the rotator cuff: analysis of outcomes and factors that predict prognosis. Audit over 18 month period[EB/OL]. https://www.shoulderdoc.co.uk/article/1342, 2009/2020-08-15. |
[3] | Bollier M, Shea K. Systematic review: what surgical technique provides the best outcome for symptomatic partial articular-sided rotator cuff tears?[J]. Iowa Orthop J, 2012, 32:164-172. |
[4] | Ryösä A, Laimi K, Äärimaa V, et al. Surgery or conservative treatment for rotator cuff tear: a meta-analysis[J]. Disabil Rehabil, 2017, 39(14):1357-1363. |
[5] | Weber S, Chahal J. Management of rotator cuff injuries[J]. J Am Acad Orthop Surg, 2020, 28(5):e193-e201. |
[6] | 中华医学会影像技术分会, 中华医学会放射学分会. MRI检查技术专家共识[J]. 中华放射学杂志, 2016, 50(10):724-739. |
[7] | Kamath G, Galatz LM, Keener JD, et al. Tendon integrity and functional outcome after arthroscopic repair of high-grade partial-thickness supraspinatus tears[J]. J Bone Joint Surg Am, 2009, 91(5):1055-1062. |
[8] | Zumstein MA, Lädermann A, Raniga S, et al. The biology of rotator cuff healing[J]. Orthop Traumatol Surg Res, 2017, 103(1S):S1-S10. |
[9] | Pownder SL, Caserto BG, Hayashi K, et al. Magnetic reso-nance imaging and histologic features of the supraspinatus tendon in nonlame dogs[J]. Am J Vet Res, 2018, 79(8):836-844. |
[10] | Gómez-Vieira LA, Gómez-Cordero NG, Geambastiani PMA, et al. Comparative study between multi-slice computed tomographic arthrography and arthroscopy in the evaluation of rotator cuff tears[J]. Rev Bras Ortop (Sao Paulo), 2019, 54(5):579-586. |
[11] | 张振勇, 王海波, 娄晓宇, 等. 磁共振肩关节造影在肩袖完全撕裂诊断的临床应用[J]. 放射学实践, 2016, 31(6):531-534. |
[12] | 赵妍, 孙毅, 孙志先, 等. 不同MRI组合序列及扫描方位对肩袖损伤诊断分级及脂肪浸润评分的影响[J]. 中华介入放射学电子杂志, 2019, 7(3):239-242. |
[13] | Etancelin-Jamet M, Bouilleau L, Martin A, et al. Diagnostic value of angled oblique sagittal images of the supraspinatus tendon for the detection of rotator cuff tears on MR imaging[J]. Diagn Interv Imaging, 2017, 98(2):161-169. |
[14] | 杨正汉, 冯逢, 王霄英, 等. 检查规范、临床策略及新技术应用[M]//杨正汉. 磁共振成像技术指南. 北京: 人民军医出版社, 2010:148-149. |
[15] | Li B, Li H, Dong L. Quantitative comparisons between relaxation enhanced compressed sensing 3D MERGE and conventional 3D MERGE for vessel wall imaging in equal scan time: preliminary studies[J]. Sci China Life Sci, 2019, 62(12):1683-1691. |
[16] | 张惠卿, 牛广明, 裴春梅, 等. 3D-MERGE序列在肩袖及其周围韧带损伤中的诊断价值[J]. 内蒙古医科大学学报, 2017, 39(4):357-361. |
[17] | 赵殿江, 张璇, 张春柱, 等. 3D MERGE序列在膝关节准动态运动轨迹模拟中的应用[J]. 临床放射学杂志, 2017, 36(2):260-263. |
[18] | 陈细香, 查云飞, 刘昌盛, 等. 3D MERGE序列在腰骶丛神经成像中的应用[J]. 影像诊断与介入放射学, 2015, 24(5):413-416. |
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