Study Of MRI Sequences In The Diagnosis Of Articular Cartilage Injury Of The Knee Joint

ObjectiveThe purpose of this study was to compare the accuracy of the four sequences of MRI in the diagnosis of articular cartilage injury of the knee and to investigate the advantage and shortage of the four sequences. In order to evaluate the most adequate sequence in detecting articular cartilage injury of the knee.Methods36 knee joints of 31 patients who were scheduled for arthroscopy from february 2008 to december 2009 in our hospital, underwent MRI scanning prior to arthroscopy included the fast spin echo T,-weighted image (T1WI-TSE), the fat-suppressed T2-weighted fast echo sequence (T2WI-TSE-SPIR), the fat suppressed proton density fast spin echo sequence (PDW-TSE-SPIR), the fat-suppressed three-dimensional fast spoiled gradient-echo sequence (3D-WATSC). There were 15 left knee,21 right knee and 19 female,12 male. The average was 52, from 17-70 years old. Five patient underwent double genu MRI scan, the other underwent singal genu MRI scan. Divided each knee side of every cartilage into five parts:the inside of femoral condyle,the surface of femoral condyle the inside of tibial plateau,the surface of tibial plateau,the patella cartilage. Investigated and diagnosed of the 180 articular cartilage surface according to Recha criteria by detecting and compared with arthroscopic examination respectively. This is the statistical method:Analyse the date by SPSS13.0. The accurate criteria of the four sequences of MRI was sensitivity,specificity,accuracy. The criteria of correlation was the value of Kappa. The value of Kappa of the four sequences of MRI according to T test(the level a =0.05). ResultsCompared with the arthroscopic result which is the gold standard, the sensitivity,specificit,accuracy and Kappa value of the TIW-TSE sequence was 63.8%,95.3%,78.8% and 0.403; The sensitivity,specificit,accuracy and Kappa value of the T2WI-TSE-SPIR sequence was 56.3%,97.6%,76.1% and 0.353. The sensitivity,specificit,accuracy and Kappa value of the PDW-TSE-SPIR sequence was 79.8%,93.0%,86.1% and 0.642; The sensitivity,specificit,accuracy and Kappa value of the 3D-WATSC was 96.8%,88.3%,92.8% and 0.812.â‘ 3D-WATS>PDW-TSE-SPIR>T1WI-TSE>T2WI-TSE-SPIR in sensitivity and specificity.â‘¡3D-WATSC was well superior to PDW-TSE-SPIR,T1WI-TSE,T2WI-TSE-SPIR in the value of Kappa.The correlation between 3D-WATSC and arthroscopy in detecting cartilage injury was remarkable.â‘¢Compared the Kappa values of all MRI sequences each other. Compared The kappa value of 3D-WATSC with PDW-TSE-SPIR,T2WI-TSE-SPIRandT1WI-TSE respectively (t>2.02, p<0.01), the difference is significant between each other. Compared The kappa value of PDW-TSE-SPIR with T2WI-TSE-SPIR, T1WI-TSE, the difference is not significant between each other. Compared The kappa value of T2WI-TSE-SPIR and T1WI-TSE, the difference is not significant between each other.ConclusionsThe accuracy and Kappa values of Fat-suppressed three-dimensional fast spoiled gradient-echo sequence (3D-WATSC) was superior to other sequences in the diagnosis of articular cartilage injury of the knee. The correlation between 3D-WATSC and arthroscopy in detecting cartilage injury was remarkable. 3D-WATSC has been deemed the most adequate sequence in detecting articular cartilage injury of the knee.