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首页> 外文期刊>Acta Radiologica >Differentiation between grade 3 and grade 4 articular cartilage defects of the knee: fat-suppressed proton density-weighted versus fat-suppressed three-dimensional gradient-echo MRI.
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Differentiation between grade 3 and grade 4 articular cartilage defects of the knee: fat-suppressed proton density-weighted versus fat-suppressed three-dimensional gradient-echo MRI.

机译：膝关节3级和4级关节软骨缺损之间的区别：脂肪抑制质子密度加权与脂肪抑制三维梯度回波MRI。

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BACKGROUND: Fat-suppressed (FS) proton density (PD)-weighted magnetic resonance imaging (MRI) and FS three-dimensional (3D) gradient-echo imaging such as spoiled gradient-recalled (SPGR) sequence have been established as accurate methods for detecting articular cartilage defects. Purpose: To retrospectively compare the diagnostic efficacy between FS PD-weighted and FS 3D gradient-echo MRI for differentiating between grade 3 and grade 4 cartilage defects of the knee with arthroscopy as the standard of reference. MATERIAL AND METHODS: Twenty-one patients who had grade 3 or 4 cartilage defects in medial femoral condyle at arthroscopy and knee MRI were included in this study: grade 3, >50% cartilage defects; grade 4, full thickness cartilage defects exposed to the bone. Sagittal FS PD-weighted MR images and FS 3D gradient-echo images with 1.5 T MR images were independently graded for the cartilage abnormalities of medial femoral condyle by two musculoskeletal radiologists. Statistical analysis was performed by Fisher's exact test. Inter-observer agreement in grading of cartilage was assessed using kappa coefficients. RESULTS: Arthroscopy revealed grade 3 defects in 17 patients and grade 4 defects in 4 patients in medial femoral condyles. For FS 3D gradient-echo images grade 3 defects were graded as grade 3 (n=15) and grade 4 (n=2), and all grade 4 defects (n=4) were correctly graded. However, for FS PD-weighted MR images all grade 3 defects were misinterpreted as grade 1 (n=1) and grade 4 (n=16), whereas all grade 4 defects (n=4) were correctly graded. FS 3D gradient-echo MRI could differentiate grade 3 from grade 4 defects (P=0.003), whereas FS PD-weighted imaging could not (P=1.0). Inter-observer agreement was substantial (kappa=0.70) for grading of cartilage using FS PD-weighted imaging, whereas it was moderate (kappa=0.46) using FS 3D gradient-echo imaging. CONCLUSION: FS 3D gradient-echo MRI is more helpful for differentiating between grade 3 and grade 4 cartilage defects than is FS PD-weighted imaging.
机译：背景：已经建立了脂肪抑制（FS）质子密度（PD）加权磁共振成像（MRI）和FS三维（3D）梯度回波成像（如变质梯度回波（SPGR）序列）作为精确的方法检测关节软骨缺损。目的：回顾性比较以关节镜作为参考标准的FS PD加权和FS 3D梯度回波MRI在区分3级和4级膝关节软骨缺损中的诊断功效。材料与方法：本研究纳入了21例经关节镜和膝关节MRI检查在股骨内侧con内有3或4级软骨缺损的患者：3级，> 50％软骨缺损; 3级软骨缺损。 4级，全厚度软骨缺损暴露于骨骼。两名肌肉骨骼放射科医生分别对矢状面FS PD加权的MR图像和具有1.5 T MR图像的FS 3D梯度回波图像对内侧股骨con的软骨异常进行了独立分级。统计分析通过Fisher精确检验进行。使用kappa系数评估了观察者之间在软骨分级中的一致性。结果：关节镜检查发现17例患者的3级缺损和4例内侧股骨con的4级缺损。对于FS 3D梯度回波图像，将3级缺陷分级为3级（n = 15）和4级（n = 2），并将所有4级缺陷（n = 4）正确分级。但是，对于FS PD加权MR图像，所有3级缺陷均被误解为1级（n = 1）和4级（n = 16），而所有4级缺陷（n = 4）均已正确分级。 FS 3D梯度回波MRI可以区分3级和4级缺陷（P = 0.003），而FS PD加权成像不能（P = 1.0）。使用FS PD加权成像，观察者之间的共识对软骨分级具有实质性（kappa = 0.70），而使用FS 3D梯度回波成像技术的观察者之间的一致性中等（kappa = 0.46）。结论：FS 3D梯度回波MRI比FS PD加权成像更有助于区分3级和4级软骨缺损。

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