质子密度与质子密度脂肪饱和磁共振成像序列诊断半月板撕裂的准确性比较：多阅片者ROC分析
简介
本研究比较了质子密度（PD）与PD脂肪抑制MRI序列在诊断半月板撕裂中的准确性。三位肌肉骨骼放射科医生对98例接受关节镜手术患者的影像进行独立阅片，以关节镜探查为金标准。结果显示，对于内侧半月板撕裂，PD序列的AUC为0.9302，敏感性93.2%，特异性87.5%；PD脂肪抑制序列的AUC为0.9229，敏感性95.9%，特异性79.2%，两者无统计学差异…
英文摘要
AIM: Compare the diagnostic performance of proton density (PD) and PD fat-saturated magnetic resonance imaging (MRI) sequences in detecting meniscal tears using receiver operating characteristic curve analysis with multiple independent readers. MATERIALS AND METHODS: This retrospective, institutional review board approved study included 98 patients who underwent knee arthroscopy for suspected meniscal tears between July 1, 2020, and January 31, 2021. Sagittal PD and PD fat-saturated MRI sequences were independently reviewed by 3 musculoskeletal radiologists on separate days. Readers rated diagnostic confidence on a 5-point scale. Diagnostic accuracy was assessed using area under the curve (AUC), DeLong tests, sensitivity, specificity, positive predictive value, and negative predictive value, with arthroscopy as the reference standard. Binary classification was based on reader scores of 4 or 5 and agreement from at least 2 of three 3 was required. RESULTS: For medial meniscal tears, PD sequences yielded an AUC of 0.9302, sensitivity of 93.2%, and specificity of 87.5%. PD fat-saturated sequences yielded an AUC of 0.9229, sensitivity of 95.9%, and specificity of 79.2% (DeLong p = 0.575). For lateral meniscal tears, AUC was 0.8329 for PD and 0.8088 for PD fat-saturated sequences (DeLong P = 0.339). CONCLUSION: Both sequences demonstrated high diagnostic performance for meniscal tear detection. Fat-saturated sequences showed slightly higher sensitivity but lower specificity. No significant difference in diagnostic accuracy was observed between sequences.