常规MRI评估组织工程软骨修复猪软骨缺损的研究  

Morphological MRI of cartilage repair tissue after tissue engineered cartilage in a pig model

作　　者：陈其春[1] 邹月芬[2] 左强[3] 范卫民[3] 郑穗生[1] 王龙胜[1] 

机构地区：[1]安徽医科大学第二附属医院放射科,安徽合肥230601 [2]南京医科大学第一附属医院放射科 [3]南京医科大学第一附属医院骨科

出　　处：《实用放射学杂志》2015年第11期1893-1896,1924,共5页Journal of Practical Radiology

摘　　要：目的 应用MRI常规序列评估猪自体骨软骨镶嵌（Mosaicplasty）联合组织工程软骨移植修复猪膝关节软骨缺损的效果,以提高对软骨修复的影像评估能力.方法 选用小型猪8只,16个膝关节用于制备骨软骨缺损动物模型.右膝以Mosaicplas ty技术联合组织工程软骨移植修复股骨内侧髁负重区软骨缺损作为实验组;左膝单纯应用Mosaicplasty技术修复软骨缺损作为对照组.术后6、12、18周及26周,进行膝关节MRI动态随访评估,26周同时行大体和组织学的评估.结果 术后实验组与对照组MR总体评分差异有统计学意义（F=101.333,P＜0.001）,实验组的修复组织MR表现明显好于对照组,主要表现在修复组织的整合情况、修复组织的表面及信号方面.MR评分与大体组织学评分显著相关（r=0.883,P＜0.001）.结论 Mosaicplasty技术联合组织工程软骨在一定程度上能够以透明样软骨修复软骨缺损,改善单纯骨软骨柱移植整合不良问题.MRI能够在体无创动态监测软骨修复组织整合修复过程,可作为软骨修复术后评估的工具.Objective To evaluate the efficacy of mosaicplasty combined with tissue-engineered cartilage for the treatment of osteochondral defects in a pig model using morphological MRI,and to improve the capacity of imaging evaluation of cartilage repair. Methods Eight adolescent miniature pigs with sixteen knees were used to establish the models with osteochodndral defects. The right knee for each pigs underwent Mosaicplasty combined with tissue-engineered cartilage as experimental group for treatment of focal full-thickness cartilage defects which created on the weight-bearing surfaces of medial condyle cartilage,while the left knees were repaired via single Mosaieplasty as control group. At 6,12,18 and 26 weeks after surgery, all knees of two groups were evaluated with a MR scanner. At 26 weeks,the repair tissue was assessed macroscopically and histologically. Results Morphological evaluation of MR showed a significant difference between two groups after surgery （F= 101. 333, P〈0. 001 ）. The repaired cartilage of the experimental group was statistically better than that of the control group,including integrated constitution, the surface characteristics and signal intensity of the repair tissue. A significant correlation was found between macroscopic scores and the MOCART scores （r= 0. 883, P〈0. 001）. Conclusion Mosalcplasty with tissue-engineered cartilage is a promising approach to regenerate osteochodndral defects as hyaline-like cartilage and promote the integration of the dead spaces of single mosaicplasty. MRI provides a noninvasive tool for monitoring the development and integration of the cartilage repair tissue and can serve as a useful tool to evaluate the progression of cartilage repair.

关 键 词：关节软骨 软骨修复 自体骨软骨镶嵌术 组织工程 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R332[医药卫生—诊断学]