应用MRI测量膝骨性关节炎滑膜厚度的方法及其临床意义  

Measurement of synovial membrane thickness in knee osteoarthritis by MRI

作　　者：叶恒[1] 李皓桓[1] 孟羿彬[1] 柯陈荣[1] 杨法宝[1] 

机构地区：[1]武汉大学人民医院骨关节外科,湖北武汉430060

出　　处：《海南医学院学报》2011年第7期1000-1003,共4页Journal of Hainan Medical University

基　　金：海南医学院科研基金资助学报项目(0020110258)~~

摘　　要：目的:探讨核磁共振成像(MRI)对膝骨性关节炎患者合并滑膜炎的严重度评估的方法及临床意义。方法:23例膝骨性关节炎患者行MRI检查。应用MRI的T2加权像检查膝关节内滑液含量和用梯度回波(GRE)检查滑膜厚度,应用ROI体积测量方法测量滑膜厚度,包括内外侧间沟和内外侧髌上囊4个区域,每个区域分0～3级,总计最大12级。其中随机选择12例患者在60d后行MRI检查并对膝关节症状进行评估,膝关节症状的评估应用Western Ontario大学和McMaster大学骨关节炎指数(WOMAC OA in-dex)和视觉模拟评分(VAS),并用三维抑脂扰相梯度回波(SPGR)序列来测量软骨体积。结果:滑膜的厚度为(1.82±0.52)级,内侧室的测量等级是(1.77±0.58)级,外侧室为(1.88±0.67)级,髌上囊和隐窝的测量等级分别是(1.95±0.50)级、(1.70±0.68)级。滑膜炎的严重程度和软骨体积的缺失有相关性(P<0.05)。结论:通过MRI可以准确和有效地测量膝骨性关节滑膜炎的严重程度。Objective： To explore the measurement of synovial membrane thickness in knee osteoarthritis by MRI.Methods： A total of 23 cases with knee osteoarthritis were examined by MRI.T2-weighted was performed to examine the content of synovial fluid and gradient echo（GRE） was performed to examine synovial membrane.Synovial membrane thickness was measured by four regions of interest（ROI） method,including four regions： media and lateral intergroove,and media and interior suprapatellar bursa,with each graded from 0 to 3,and the maximum grade of 12.Twelve patients were randomly selected and evaluated on the 60th day by Western Ontario and McMaster Universities OA Index and visual analog scale.And cartilage volume was measured by spoiled gradient recalled（SPGR） sequence.Results： The grade of synovial membrane thickness was 1.82±0.52,of media compartment was 1.77±0.58,of lateral compartment was 1.88±0.67,of suprapatellar was 1.95±0.50 and of recessbursa was 1.70±0.68.The severity of synovitis was positively correlated with cartilage volume（P〈0.05）.Conclusions： The severity of knee osteoarthritis can be accurately and effective determined by MRI.

关 键 词：骨关节炎 滑膜炎 磁共振成像 评分系统 

分 类 号：R684.3[医药卫生—骨科学]