Knee Joint: Comprehensive Assessment With 3D-FSE-Cube Sequence MR Imaging-Diagnostic Performance Compared With That Of Conventional MR Imaging At 1.5T

Purpose: To evaluate if 1.5T magnetic resonance 3D-FSE-Cube sequence imaging is superior to conventional sequence imaging in showing the injury of knee joint, and determine the clinical value of 3D-FSE-Cube in the diagnosis of knee joint injury. Materials and Methods: 63 knee joints of 56 patients ( single knee joint of 49 patients and double knee joints of 7 patients ) with varying degree knee joint injury in our hospital during February 2010 and November 2010, were collected in our study which all received 3D-FSE-Cube sequence image and conventional sequence image ( Coronal FSE-T1WI, Coronal FRFSE-PdWI/T2WI,Sagittal FRFSE-PdWI/T2WI ) before arthroscopies, only 29 patients ( all single knee ) have received arthroscopic surgery within a week on average ( ranging from 4 days two weeks ) after the MRI exam, and one more patient with anterior cruciate ligament reconstruction have also received this MRI exam. The results of arthroscopic surgery were used as reference standard, comparing the sensibility, specificity and veracity of 3D-FSE-Cube sequence and conventional sequence in the diagnosis of knee joint meniscus injuries, torn ligament and articular cartilage lesions. The Wilson scoring method was used to determine the 95% confidence intervals for sensibility and specificity. The chi-square statistics was used as the test of significance comparing the grading results of the two different magnetic resonance image in the diagnosis of knee joint meniscus injuries, torn ligament and articular cartilage lesions(when n<40 or actual frequency <5,use the Fisher exact probability test).Results: The results of arthroscopic surgery were used as reference standard. In diagnosis of articular cartilage lesions, the sensibility of 3D-FSE-Cube sequence and conventional 71.8% and 55.2% respectively, 3D-FSE-Cube sequence has significantly higher sensibility, specificity and veracity than conventional sequence (P≤0.05); In diagnosis of torn ligament, the sensibility of 3D-FSE-Cube sequence and conventional sequence are 76.9% and 53.8% respectively, the specificity 87.5% and 75%, the veracity 82.8% and 65.5% respectively, the sensibility, specificity and veracity of 3D-FSE-Cube sequence in diagnosis of torn ligament are higher than that of conventional sequence, but all have no significant difference in statistics (P≤0.05); In diagnosis of knee joint meniscus injuries, the sensibility of 3D-FSE-Cube sequence and conventional sequence are 82.9% and 77.1% respectively, the specificity 95.0% and 91.4%, the veracity 92.5% and 88.5% respectively, though conventional sequence has higher sensibility, specificity and veracity than 3D-FSE-Cube sequence , they had no significant difference in statistics.Conclusion: In this research, 3D-FSE-Cube sequence is superior to conventional sequence in evaluation of articular cartilage lesions, although 3D-FSE-Cube sequence is superior to conventional sequence in evaluation of knee joint meniscus injuries and torn ligament but they have no significant difference in statistics (P≤0.05).