核磁共振T2-star-mapping成像软骨定量分析在膝关节骨性关节炎诊断中的应用研究  

Application of MRI T2-star-mapping imaging for cartilage quantitative analysis on the diagnosis of knee osteoarthritis

作　　者：白志刚[1,2] 寇博[3] 孙玺淳[1,2] 马军[1,2] 杨绿林[1,2] 黄朋[1,2] 李立新[1,2] 尚小可[1,2] 万宁军[1,2] 

机构地区：[1]西北民族大学第一附属医院,宁夏银川750002 [2]宁夏人民医院骨科,宁夏银川750002 [3]宁夏石嘴山市第一人民医院骨科,宁夏石嘴山753200

出　　处：《宁夏医学杂志》2017年第1期27-29,共3页Ningxia Medical Journal

基　　金：中央高校基本科研业务费专项资金项目(31920140075)

摘　　要：目的探讨核磁共振T2-star-mapping成像软骨定量分析技术在膝骨性关节炎(OA)诊断中的临床意义。方法选正常志愿者22例共22个膝关节为正常对照组,选轻度、中度、重度OA患者各20例共60个膝关节作为病例组。采用GE 3.0 T磁共振扫描仪,行膝关节T2-star-mapping成像,获得股骨内侧髁关节面、股骨外侧髁关节面、胫骨内侧髁关节面、胫骨外侧髁关节面、髌骨软骨面的T2*值,比较各组T2*值的差异。结果正常对照组关节软骨的平均T2*值为(21.74±3.82)ms;轻度OA组关节软骨的平均T2*值为(27.55±5.48)ms,中度OA组关节软骨的平均T2*值为(35.01±8.83)ms;重度OA组关节软骨的平均T2*值为(41.14±14.20)ms;轻度、中度、重度OA组关节软骨的平均T2*值均较正常对照组关节软骨T2*值明显升高。各OA组膝关节的5个不同部位软骨的T2*值均较对照组升高,随着关节软骨退变程度加重,对应的T2*值随之升高,差异有统计学意义(P<0.05)。结论磁共振T2-star-mapping成像软骨定量分析技术,通过量化分析微观结构关节软骨内部组织成分变化,有利于在关节软骨发生形态学改变之前即发现关节软骨内病变,对早期膝关节软骨损伤的诊断和监测具有较高的临床应用价值。Objective To investigate the clinical significance of MRI T2- star- mapping imaging for cartilage quantitative analysis on the diagnosis of knee osteoarthritis. Methods Twenty- two cases of normal volunteers were selected as the control groupconsisting of 20 knees. 60 cases with OA were included as patient groups,20 cases with clinically diagnosed mild OA,20 cases with moderate OA and 20 cases with severe OA. The T2 values of articular surface of medial femoral condyle,articular surface of lateral femoral condyle,articular surface of medial tibial condyle,articular surface of lateral tibial condyle,and cartilage of patella were obtained by using GE 3. 0T MRI scanner and the T2- star- mapping imaging; and the inter- group differences in T2 values were compared. Results The mean T2 value of articular cartilage was respectively（ 21. 74 ± 3. 82） ms,（ 27. 55 ± 5. 48） ms,（ 35. 01 ± 8. 83） ms and（ 41. 14 ± 14. 20）ms in the normal control group,mild OA group,moderate OA group and severe OA group. Compared with the T2 value of articular cartilage in the normal control group,the T2 values of articular cartilage in the mild OA group,the moderate OA group and the severe OA group were significantly increased. Compared with the normal control group,the T2 values of cartilages at these five sites were increased in all OA groups; as the articular cartilage degeneration was aggravated,corresponding T2 values were increased,indicating a statistically significant difference（ P〈0. 05）. Conclusion Through quantitative analysis of the changes in internal tissue components of articular cartilages at the level of microstructure,MRI T2- star- mapping imaging for cartilage quantitative analysis can contribute to the early identification of articular cartilage lesions before the onset of morphological changes in articular cartilage. And it has good clinical value in the diagnosis and monitoring of early articular cartilage injuries.

关 键 词：膝关节骨性关节炎 关节软骨 T2-star-mapping成像 

分 类 号：R684.3[医药卫生—骨科学]