急性损伤所致膝关节软骨下骨髓病变与被覆软骨T2弛豫时间变化的磁共振研究  

MRI Study of the Changes of Overlying Cartilage T2 Relaxation Time and Subchondral Bone Marrow Lesion Caused by Acute Trauma in Knee Joint

作　　者：陈凯 徐凯[2] 王佳丽[2] 韩曙光[2] 鹿彩銮[2] 张秀莉[2] 孟闫凯[2] 

机构地区：[1]江苏省徐州市解放军第九七医院影像科 [2]江苏省徐州市徐州医学院附属医院影像科

出　　处：《中国医学计算机成像杂志》2015年第4期367-371,共5页Chinese Computed Medical Imaging

摘　　要：目的:利用T2弛豫时间图(T2 mapping)技术测量膝关节急性损伤后软骨下骨髓病变(subchondral bone marrow lesion,SBML)被覆软骨的T2弛豫时间(T2 relaxation time,T2 RT),并初步探讨膝关节急性损伤后SBML与被覆软骨T2 RT之间的关系及临床意义。方法:收集因急性损伤及临床诊断骨性关节炎(osteoathritis,OA)所致膝关节疼痛前来就诊58例患者,将其分为急性损伤组28例,OA组30例。另外选择20例健康志愿者膝关节作为正常对照组。将膝关节软骨分为三个分区:髌骨软骨、股骨髁软骨及胫骨平台软骨。正常对照组中分别测量三个分区内软骨的平均T2 RT。在急性损伤组和OA组中,测量SBML被覆软骨的T2 RT以及急性损伤组中邻近非SBML区域被覆软骨的T2 RT,并进行比较。测量急性损伤组中SBML的体积,且与其被覆软骨T2 RT进行相关性分析。结果:在正常对照组中,三个膝关节软骨分区内髌骨软骨的T2RT较股骨髁软骨、胫骨平台软骨偏低(P<0.05)。急性损伤组SBML被覆软骨的T2 RT较正常对照组膝关节软骨以及急性损伤组中非SBML被覆软骨的T2 RT升高(P<0.05),而与OA组SBML被覆软骨之间的T2 RT比较无统计学意义(P>0.05);急性损伤组SBML体积与其被覆软骨的T2 RT之间无相关性。结论:利用T2mapping技术测量软骨T2 RT可以发现急性损伤后膝关节SBML被覆软骨在形态变化之前的内部改变;并且提示其可能存在更高发生OA的风险。Purpose： To study T2 relaxation time （T2 RT） about overlying cartilage of subchondral bone marrow lesion （SBML） in knee joint after acute injure through T2 mapping technique, and to preliminary discuss the relationship and clinical significance about SBML after acute trauma and T2 RT changes of overlying cartilage. Methods： Fifty-eight patients with knee pain caused by acute trauma or osteoarthritis （OA） were treated as patient groups, which included 28 patients in acute trauma group and 30 patients in OA group. And 20 healthy volunteers were served as the control group. In the control group, the cartilage of the whole knee was divided into three subregions： patella cartilage, femoral condyle cartilage and tibial plateau cartilage, and their mean T2 RT was measured. In patient groups, all overlying cartilages of SBML manifested normal morphology in routine MRI scan, T2 RT of which and near non-SBML in acute trauma group were aquired according to subregions of knee as well as the control group. Then, based on the subregions of whole knee cartilage, the T2 RT of overlying cartilage with SBML in acute trauma group was compared with OA group, control group and non-SBML group. The SBML volume in the acute trauma group was measured, and correlated with SBML overlying cartilage T2 RT. Results： In the three subregions of whole knee, T2 RT of patella cartilage in the control group was lower than that of femoral condyle cartilage and tibial plateau cartilage, the difference was with statistical significance （P〈0.05）. The T2 RT of overlying cartilage with SBML in acute trauma group was higher than that in the control group and non-SBML group, the difference was with statistical significance （P〈O.05）, and there was not statistical significant difference between acute trauma group and OA group （P〉0.05）. In acute trauma group, SBML volume had no correlation with overlying cartilage T2 RT. Conclusion： The overlying cartilage with SBML caused by acute trauma in knee joint can be detected b

关 键 词：膝关节 软骨 T2弛豫时间 软骨下骨髓病变 急性损伤 骨性关节炎 

分 类 号：R684[医药卫生—骨科学] R445.2[医药卫生—外科学]