Diagnostic value of MR 3D-PD-SPACE fat saturation sequence combined with conventional MR imaging for atlantoaxial subluxation
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摘要:
目的 研究三维可变翻转角空间优化对比度完善技术质子加权成像（MR 3D-PD-SPACE）抑脂序列联合常规MRI成像对寰枢关节半脱位的诊断价值。 方法 选取我院2017年1月~2020年1月收治的43例疑似寰枢关节半脱位患者作为研究对象。患者均接受MR 3D-PD-SPACE抑脂序列联合MRI成像检查，以CT三维重建表面遮盖法作为金标准，对比两种检查方式的阳性率，同时绘制ROC曲线分析MR 3D-PD-SPACE抑脂序列联合常规MR成像对寰枢关节半脱位的诊断价值。 结果 通过金标准发现43例疑似寰枢关节半脱位患者40例明确寰枢关节半脱位诊断，阳性率为93.02%。MR诊断寰枢关节半脱位阳性36例，阳性率为83.72%；MR 3D-PD-SPACE抑脂序列联合常规MR成像诊断寰枢关节半脱位阳性39例，阳性率为90.69%；MR 3DPD-SPACE抑脂序列联合常规MRI成像诊断寰枢关节半脱位敏感度为97.5%，特异性为100.0%；常规MRI诊断寰枢关节半脱位敏感度为90.00%，特异性为33.3%；MR 3D-PD-SPACE抑脂序列联合常规MRI诊断价值远高于MRI单独检测（P < 0.05）。 结论 MR 3D-PD-SPACE抑脂序列联合常规MRI成像可有效提高对于寰枢关节半脱位的诊断价值。 -
关键词:
- MR 3D-PD-SPACE抑脂序列 /
- MR成像 /
- 寰枢关节半脱位 /
- 诊断价值
Abstract:Objective To analyze the diagnostic value of magnetic resonance three- dimension sampling perfection with application optimized contrasts using different flip angle evolution (MR 3D-PD-SPACE) fat saturation sequence combined with conventional MRI for atlantoaxial subluxation. Methods A total of 43 patients with suspected atlantoaxial subluxation admitted to our hospital from January 2017 to January 2020 were selected. All patients received MR 3D-PD-SPACE fat saturation sequence combined with conventional MRI examinations. Taking spiral CT angiography in surface displaytechnique as gold standard, the positive rates of the two examination methods were compared. ROC curve was drawn to analyze the value of MR 3D-PD-SPACE fat saturation sequence combined with conventional MRI in the diagnosis of atlantoaxial subluxation. Results The gold standard identified 40 patients with atlantoaxial subluxation in 43 suspected cases with a positive rate of 93.02%. MRI diagnosis of atlantoaxial subluxation screened 36 cases, with a positive rate of 83.72%, while MR 3D-PD-SPACE fat saturation sequence combined with conventional MRI screened 39 cases, with a positive rate of 90.69%. The sensitivity and specificity of MR 3D-PD-SPACE fat saturation sequence combined with conventional MRI for the diagnosis of atlantoaxial subluxation were 97.5% and 100.0%, while the sensitivity and specificity of conventional MRI for the diagnosis of atlantoaxial subluxation were 90.00% and 33.3%, The diagnostic value of MR 3D-PD-SPACE fat saturation sequence combined with conventional MRI was significantly better than that of MRI diagnosis (P < 0.05). Conclusion MR 3DPD-SPACE fat saturation sequence combined with conventional MRI is of great clinical value in the diagnosis of atlantoaxial subluxation. -
图 1 典型病例MRI影像学表现
A: 头颈部冠状位扫描示寰枢椎处均匀较高信号; B~C: 颈部横断位扫描示寰齿前间隙>3 mm或者齿突侧块之间差>3 mm.
Figure 1. MRI imaging findings of typical cases.
图 2 3D-PD-SPACE抑脂序列联合常规MR成像对寰枢关节半脱位的诊断价值分析
Figure 2. Analysis of the diagnostic value of 3DPD-SPACE fat saturation sequence combined with conventional MRI in the diagnosis of atlantoaxial subluxation.
表 1 MR 3D-PD-SPACE抑脂序列联合常规MR成像对寰枢关节半脱位的诊断价值
Table 1. Diagnostic value of MR 3D-PD-SPACE fat saturation sequence combined with conventional MRI in the diagnosis of atlantoaxial subluxation
项目 标准误 AUC P 95% CI 敏感度(%) 特异性(%) 常规MRI成像 0.189 0.617 0.505 0.246~0.987 90.0 33.3 MR 3D-PD-SPACE抑脂序列联合常规MRI成像 0.016 0.987 0.005 0.956~1.000 97.5 100.0 MR 3D-PD-SPACE：三维可变翻转角空间优化对比度完善技术质子加权成像. 
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