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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

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  • 1.苏州大学医学部,江苏 苏州 215006
    2.南京中医药大学昆山附属医院 a.放射科,b.关节骨科,江苏 昆山 215300
    3.上海交通大学医学院附属瑞金医院放射科,上海 200025
    4.苏州大学附属第二医院放射科,江苏 苏州 215004

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

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  • 1. Medical College of Soochow University, Jiangsu Suzhou 215006
    2. a. Department of Radiology, b. Department of Joint Orthopedics, Kunshan Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Kunshan 215300
    3. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025
    4. Department of Radiology, the Second Affiliated Hospital of Soochow University, Jiangsu Suzhou 215004, China

Received date: 2020-08-20

  Online published: 2022-06-28

摘要

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。

本文引用格式

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

Abstract

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.

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