微骨折术治疗膝关节软骨损伤修复效果T_2 star mapping评价研究  

Quality evalution of articular cartilage repair after Micro-fracture therapy via T_2 * mapping

作　　者：伍忠根[1] 傅闽兰[1] 李志国[1] 万林[1] 郭珍珍[1] 刘小涛[1] 

机构地区：[1]江西省吉安市中心人民医院磁共振室,江西吉安343000

出　　处：《医学影像学杂志》2014年第9期1599-1603,共5页Journal of Medical Imaging

摘　　要：目的 本研究应用MRI对关节镜下微骨折法治疗膝关节软骨损伤修复效果进行大体组织形态学评估及定量分析.方法 本研究纳入14例有膝关节软骨损伤症状并接受关节镜下微骨折法治疗的病例进行回顾性病例分析.所有病例的关节软骨损伤均为ICRS分级Ⅲ或Ⅳ,术中测量病变面积为2～8cm^2.1年随访期内所有病例都接受常规MRI序列及T2 star mapping序列扫描（1.5T）.对损伤修复区域采用软骨组织修复磁共振观察评分系统（MOCART）进行评价.采用T2 star mapping序列扫描图像感兴趣区划分的方法对修复区域及自身正常软骨所测量的T2＊弛豫值进行分析比较.结果 1年随访期软骨修复区MOCART评分为59.50±23.90,相邻本体软骨组织评分为65.21±21.84,与软骨修复组间比较无显著差异.软骨修复区和邻近正常自体软骨组织T2＊弛豫时间分别为（31.14±9.26）ms和（32.93±11.69）ms,修复区软骨组织质地与正常软骨组织相近.结论 经关节镜下微骨折法修复膝关节软骨损伤后1年随访观察期内,MRI软骨扫描可见软骨损伤区填充良好.经T2＊测量值分析证实软骨修复组织可以达到与邻近正常透明软骨相近的组织结构.Objective The purpose of our study was to investigate the morphological outcome and to perform the quanti- tative analysis by MRI for the cartilage tissues repair after arthroscopic micro-fracture therapy. Methods Our retrospec- tive case series involved 14 patients with symptomatic chondral defects in the knee and accepted arthroscopic micro-fracture therapy. All defects were ICRS grade Ⅲ or Ⅳ, and the intra-operative measured lesion areas were about 2-8 cm^2. All patients accepted T2 star mapping and morphological MRI scan at 1.5 T by 1-year follow-up. The repair cartilages were e- valuated by the magnetic resonance observation of cartilage repair tissue （MOCART）. The region of interest （ROI）delin- eate method of T2 star mapping image was used to analyze the T2 star relaxation values between the repair area and health native cartilage. Results The MOCART score between repair cartilage area and native health cartilage had no significant deviation at 1-year follow-up, which was 59.50 ± 23.90 and 65.21 ± 21.84 respectively. The T2 star relaxation values sug- gested the similar tissue properties between repair cartilage area and native health cartilage, which was （31.14±9.26） ms and （32.93±11.69） ms respectively. Conclusion The MRI scan at 1-year follow-up proved the well repair of the cartilage lesions, which were accepted arthroscopic micro-fracture therapy. The T2 star relaxation values confirmed that the repair tissue achieved similar values compared to normal native cartilage.

关 键 词：软骨修复 微骨折术 核磁共振成像 T2 star mapping序列 

分 类 号：R684[医药卫生—骨科学] R445.2[医药卫生—外科学]