Clinical study on improving the diagnostic accuracy of adult elbow joint cartilage injury by multisequence magnetic resonance imaging

Table 1 Magnetic resonance imaging scan sequence and parameter settings

	TR (ms)	TE (ms)	Matrix of images	Slice thickness (mm)	Layer spacing (mm)	Scan duration (min)
T1WI	550	15	256×256	5	0.6	6
T2WI	4000	102	256×256	4	0.5	7
PDWI	3000	30	256×256	3	0.4	7
T2*WI	560	15	256×256	3	0.6	6
3D-CISS	700	12	512×512	1.5	0.3	5

T1WI: T1-weighted imaging; T2WI: T2-weighted imaging; PDWI: Proton density weighted imaging; T2*WI: T2*-weighted imaging; 3D-CISS: Three-dimensional water imaging sequence; TR: Repetition time TE: Time to echo.

Table 2 Characteristics of the patients at baseline, n (%)

	Overall (n = 60)	Male (n = 35)	Female (n = 25)	t/χ2	P value
Age (yr)	38.4 ± 10.2	39.5 ± 10.5	36.8 ± 9.8	1.009	0.317
Body mass index (kg/m²)	25.3 ± 4.2	26.1 ± 3.9	24.2 ± 4.5	1.745	0.086
Duration of pain (mo)	6.2 ± 3.7	5.9 ± 3.3	6.6 ± 4.1	-0.732	0.467
Smoking (yes)	18 (30)	12 (34.3)	6 (24.0)	0.327	0.567
Past history of elbow joint (yes)	10 (16.7)	6 (17.1)	4 (16.0)	0.014	0.906

Table 3 Performance of magnetic resonance imaging sequences in the diagnosis of cartilage injury in the elbow

	Diagnostic sensitivity (%)	Diagnostic specificity (%)	Accuracy (%)	Positive predictive value (%)	Negative predictive value (%)
T1WI	81.67 [49/60]	78.33 [47/60]	79.67 ± 6.54	76.47 ± 7.32	82.61 ± 5.88
T2WI	83.33 [50/60]	71.67 [43/60]a	75.00 ± 5.58a	68.49 ± 7.25a	84.75 ± 4.47
PDWI	70.00 [42/60]b	85 [51/60]a,b	78.33 ± 5.25	82.35 ± 6.65a,b	74.19 ± 6.01a,b
T2*WI	78.33 [47/60]c	78.33 [47/60]b,c	77.96 ± 5.99	73.53±7.44b,c	80.77 ± 6.20c
3D-CISS	90.00 [54/60]a,b,c,d	88.33 [53/60]a,b,d	89.34 ± 4.98a,b,c,d	87.10 ± 5.18a,b,c,d	92.31 ± 4.13a,b,c,d

^aP < 0.05, compared with T1W1.

^bP < 0.05, compared with T2W1.

^cP < 0.05, compared with PDW1.

^dP < 0.05 compared with T2*W1.

T1WI: T1-weighted imaging; T2WI: T2-weighted imaging; PDWI: Proton density weighted imaging; T2*WI: T2*-weighted imaging; 3D-CISS: Three-dimensional water imaging sequence.

Table 4 Accuracy of magnetic resonance imaging sequence combinations in the diagnosis of different grades of elbow cartilage injury

	Mild injury accuracy (%)	Moderate injury accuracy (%)	Severe injury accuracy (%)
T1WI+T2WI	78.26b,c	84.62b,c	80.00b,c
PDWI+3D-CISS	86.96a,c	92.31a,c	86.67a,c
T2*WI+PDWI	82.61a,b	88.46a,b	73.33a,b
Full sequence union	91.30a,b,c	96.15a,b,c	93.33a,b,c

^aP < 0.05, compared with T1W1+T2W1.

^bP < 0.05, compared with PDW1+3D-CISS.

^cP < 0.05, compared with T2*W1+PDW1.

T1WI: T1-weighted imaging; T2WI: T2-weighted imaging; PDWI: Proton density weighted imaging; T2*WI: T2*-weighted imaging; 3D-CISS: Three-dimensional water imaging sequence.

Table 5 Concordance analysis between arthroscopic diagnosis and magnetic resonance imaging sequence diagnosis, n (%)

	No. of joints	No. of agreements	No. of inconsistencies	Kappa value	P value
Arthroscopy and T1WI	60	42 (70.00)	18 (30.00)	0.650	< 0.001
Arthroscopy and T2WI	60	45 (75.00)	15 (25.00)	0.720	< 0.001
Arthroscopy and PDWI	60	48 (80.00)	12 (20.00)	0.760	< 0.001
Arthroscopy and T2*WI	60	40 (66.67)	20 (33.33)	0.620	< 0.001
Arthroscopy and 3D-CISS	60	52 (86.67)	8 (13.33)	0.840	< 0.001
Arthroscopy was combined with all MRI sequences	60	55 (91.67)	5 (8.33)	0.890	< 0.001

T1WI: T1-weighted imaging; T2WI: T2-weighted imaging; PDWI: Proton density weighted imaging; T2*WI: T2*-weighted imaging; 3D-CISS: Three-dimensional water imaging sequence; MRI: Magnetic resonance imaging.