膝关节基质诱导自体软骨细胞移植术：软骨修复的磁共振评价  

Matrix Associated Autologous Chondrocyte Implantation of Knee:Evaluation of Cartilage Repairwith T_2 mapping and 3D-SPGR Sequences

作　　者：苏刚[1,2] 戴雪松[3] 乐剑平[4] 孙建忠[1] 王加伟[1] 徐雷鸣[1] 

机构地区：[1]浙江大学医学院附属第二医院放射科,杭州310009 [2]嘉兴市第二医院 [3]浙江大学医学院附属第二医院骨科,杭州310009 [4]安徽省芜湖市中医院放射科,241000

出　　处：《临床放射学杂志》2016年第6期914-918,共5页Journal of Clinical Radiology

摘　　要：目的探讨磁共振T2-mapping和3D-SPGR技术在评估膝关节基质诱导自体软骨细胞移植术后软骨修复的作用。方法 9例膝关节软骨损伤患者,接受自体软骨细胞移植术治疗,在术后不同时间进行临床Lysholm评分评价,同时行磁共振检查。测量各时间点移植区与正常区软骨全层的T2值,并计算移植区与正常区软骨T2比值Z;移植软骨各时间点厚度及周围正常软骨厚度,并进行统计学分析。各个时间点移植区与正常区T2值比较采用配对t检验,Z值与Lysholm评分采用Spearman秩和检验。结果术后移植区T2值均大于正常区,移植软骨均增厚。各个时间点移植区与正常区T2值配对t检验差异有统计学意义(P=0.004);Z值与Lysholm评分有统计学意义(r=-0.645,P=0.017)。随着术后时间的延长,移植区T2值降低,软骨厚度增加。结论磁共振T2-mapping联合3D-SPGR能够无创、动态地监测自体软骨细胞移植术后软骨的修复过程,可作为软骨修复术后评估的重要工具。Objective To explore the availability of T2 mapping and 3DSPGR MR imaging for evaluating of the cartilage repair post-operation of the matrixinduced autologous chondrocyte implantation（MACI）.Methods Nine patients with chondral injuries of knee were underwent interventional therapy of the MACI.All patients were evaluated by clinic Lysholm score in different time and were performed the imaging assessment in the same period with T2-mapping and 3D-SPGR sequences by a 3.0T MR scanner.Fullthickness mean T2 values and the thickness of the cartilage were measured in the transplanted and normal zones.Z ratio was calculated by T2 value between the transplanted and normal zones.Paired t-tests were available to compare the T2 values between transplanted and normal cartilaginous areas.Spearman Rank-Sum test were used to compare the Z ratio and the Lyshoml score.Results The T2 values of the transplanted zones after MACI were higher than the normal cartilaginous zones respectively.The thickness of the transplanted cartilage had been gradually increasing There were significant differences of the T2 values between the transplanted and normal cartilaginous zone（both P =0.004） after the MACI.The Z ratio and the Lyshoml score had statistical significance（r =- 0.645,P = 0.017.The Z ratio had been gradually decreasing and was close to 1 after prolonging post-operation.Conclusion MR T2-mapping and 3DSPGR sequences were available for evaluation ofthe cartilage repair post-operation of the MACI.

关 键 词：磁共振成像 膝关节 软骨 软骨细胞移植 T2值 

分 类 号：R684[医药卫生—骨科学] R445.2[医药卫生—外科学]