本文選題：各項(xiàng)同性　切入點(diǎn)：膝關(guān)節(jié)　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的運(yùn)用1.5T磁共振掃描膝關(guān)節(jié),通過3D-SPACE(三維快速自旋回波序列)掃描得出的各項(xiàng)同性數(shù)據(jù),多平面重組觀察半月板,得出診斷結(jié)果。常規(guī)2D SE掃描序列得出的圖像診斷半月板損傷,比較兩者在半月板損傷中的診斷價(jià)值,以及在半月板分級診斷中的準(zhǔn)確率。方法在膝關(guān)節(jié)半月板損傷病人檢查時(shí),常規(guī)SE序列掃描同時(shí)加做3D-SPACE序列,所有病例均進(jìn)行常規(guī)2D-FSE序列,包括冠狀位、矢狀位、軸位2D-FSE序列,以及3D-SPACE(三維快速自旋回波序列)序列,并進(jìn)行膝關(guān)節(jié)鏡檢查,來評價(jià)半月板損傷的情況。觀察兩種掃描方法得出的圖像,分別記錄其診斷結(jié)果,以膝關(guān)節(jié)鏡檢查為金標(biāo)準(zhǔn),比較兩種掃描方法在半月板損傷中的診斷符合率,探討3D-SPACE序列在半月板損傷分級診斷中的應(yīng)用價(jià)值。結(jié)果1、3D-SPACE(三維快速自旋回波序列)序列診斷半月板損傷的特異度為95.92%、敏感度為90.57%、陽性預(yù)測值為96%、陰性預(yù)測值為98%、準(zhǔn)確率為95%。2D序列診斷半月板損傷的特異度為92%、敏感度為92.16%、陽性預(yù)測值為94%、陰性預(yù)測值為96%、準(zhǔn)確率為93%。3D-SPACE序列和2D常規(guī)掃描序列在半月板損傷中診斷符合率分別為95%和93%,用卡方檢驗(yàn)進(jìn)行比較兩種序列在半月板損傷的診斷符合率,X2=0.355,P0.05,差異沒有統(tǒng)計(jì)學(xué)意義。2、3D-SPACE(三維快速自旋回波序列)序列獲得的各項(xiàng)同性數(shù)據(jù),可以進(jìn)行多平面重組觀察,因此可以將半月板損傷的微小細(xì)節(jié)顯示的比較清楚,減少了由于部分容積效應(yīng)帶來的比較模糊的關(guān)節(jié)損傷,可以更好的顯示半月板周圍的細(xì)小結(jié)構(gòu)的關(guān)系,對于常規(guī)2D序列因部分容積效應(yīng)不能明確分級的Ⅱ、Ⅲ級信號可以更好的顯示。用卡方檢驗(yàn)進(jìn)行比較兩者的診斷準(zhǔn)確率,X2=0.024,P0.05,差異有統(tǒng)計(jì)學(xué)意義,可以認(rèn)為3D-SPACE較2D-FSE序列在半月板損傷分級診斷中準(zhǔn)確率更高。結(jié)論3D-SPACE序列作為一種新的MR成像技術(shù),能夠快速采集達(dá)到各項(xiàng)同性的高分辨率圖像,通過多平面重組觀察,可以更為準(zhǔn)確的顯示半月板的解剖結(jié)構(gòu)及周圍微小結(jié)構(gòu),對于1毫米以下的半月板損傷仍然能十分清楚的顯示。3D-SPACE與常規(guī)序列在診斷半月板損傷中具有相似的診斷能力,但在明確半月板損傷分級診斷中具有較明顯的優(yōu)勢,對于是否達(dá)到關(guān)節(jié)鏡的手術(shù)指證提供更多的影像學(xué)依據(jù),術(shù)前定位更加準(zhǔn)確,在診斷膝關(guān)節(jié)半月板損傷中具有潛在的應(yīng)用價(jià)值。
[Abstract]:Objective to use 1.5T magnetic resonance imaging (MRI) to scan knee joint and observe meniscus by 3D-SPACE (3D fast spin echo sequence). The diagnostic results were obtained. The conventional 2D SE scan sequence was used to diagnose meniscus injury, and the diagnostic value of them in meniscus injury was compared. Methods the routine SE sequence and 3D-Space sequence were performed simultaneously in the diagnosis of meniscus injury of knee joint. All cases were performed 2D-FSE sequence, including coronal, sagittal and axial 2D-FSE sequences. And 3D-SPACE3 (3D fast spin echo sequence) sequence and knee arthroscopy were performed to evaluate the meniscus injury. The images obtained by the two scanning methods were observed, and the diagnostic results were recorded respectively, and the knee arthroscopy was regarded as the gold standard. The diagnostic coincidence rate of two scanning methods in meniscus injury was compared. To explore the application value of 3D-Space sequence in the diagnosis of meniscus injury classification. Results the specificity, sensitivity, positive predictive value and negative predictive value of 3D-SPACE3D-SPACE sequence in the diagnosis of meniscus injury were 95.92, 90.57, 96 and 98, respectively. The specificity, sensitivity, positive predictive value, negative predictive value and accuracy of 95.2D sequence for the diagnosis of meniscus injury were 92. 16, 92. 16, 94, 96, 933 and 95%, respectively. The diagnostic coincidence rate of the two sequences in meniscus injury was compared by chi-square test. The difference was not statistically significant. The difference was not statistically significant. It is possible to perform multiplanar reconfiguration observations, so that the minute details of meniscus injuries can be shown more clearly, reducing the blur of joint damage due to partial volumetric effects. The relationship between the small structures around the meniscus can be better displayed. For the 鈪，

本文編號：1589219