磁共振T_2-mapping与质子密度加权像成像在髌软骨军事训练伤中的早期诊断对比分析  

Magnetic resonance T_2-mapping and imaging the patellar cartilage PDWI military servicemen in early diagnosis of comparative analysis

作　　者：黄科峰[1] 伍晓刚[1] 朱安平[1] 黄华[1] 况兵[1] 程玉青[1] 宋君[1] 方晓熠[1] 应文魁[1] 陈庆[1] 

机构地区：[1]解放军第477医院放射科,襄阳441003

出　　处：《实用医学影像杂志》2017年第1期34-36,共3页Journal of Practical Medical Imaging

摘　　要：目的比较磁共振T2-mapping与质子密度加权像(PDWI)成像在髌软骨军事训练伤中的早期诊断价值。方法对78例关节进行磁共振检查,数据传输到GE工作站(ADW4.6),经Functool中T2-mapping软件处理后产生髌软骨的伪彩图,选择puh thallium和3 colors,色彩范围20~80 ms,用2 ms作为增量。分析轴位PDWI和T2-mapping图像,确认软骨异常病灶,在PDWI序列上软骨损伤病灶定义为髌软骨信号强度改变,在T2-mapping上软骨病灶定义为肉眼能看到的T2值明显升高的局限性区域,将病灶和彩色尺度条比较进行分级,在T2-mapping伪彩图3 colors上将病灶分3个等级,一级蓝色(20~40 ms),二级绿色(41~60 ms),三级红色(61~80ms)。结果 T2-mapping显示髌软骨异常者78例共89个病灶,在T2-mapping伪彩图上分级,一级病灶32个,二级病灶48个,三级病灶9个。其中45个病灶在T2-mapping与PDWI上均能发现,占51%,但T2-mapping显示的深度与宽度大于PDWI。余44个病灶仅在T2-mapping上发现,占49%,其中一级病灶30个,占34%,二级病灶14个,占16%。三级病灶9个占10%,在T2-mapping与PDWI上均能发现,显示深度与宽度基本相同。结论 T2-mapping成像通过测量T2弛豫时间可发现没有发生明显形态学改变的髌软骨早期损伤的组织成分变化,从而有效指导临床早期诊断及治疗,防止软骨发生不可逆性损伤,对保证战士战斗力具有重要的军事和临床价值。Objective To compare the early diagnosis value of MR T2-mapping and military servicemen PDWI imaging in patellar cartilage. Methods Seventy-eight cases of joints for magnetic resonance imaging, data transmission to the GE workstation（ADW4.6）, after Functool T2-mapping software treatment of patellar cartilage pseudo color map, choose puh thallium and 3 colors, color range 20-80 ms, use 2 ms as incremental. Analysis axis PDWI and T2-mapping image, confirm the abnormal cartilage lesions, cartilage injury lesions on PDWI sequence is defined as the patellar cartilage, the changes of signal intensity on T2-mapping cartilage lesions is defined as the naked eye can see T2 values significantly increased the limitation of the area, compare and grade article lesions and color measurement,on T2-mapping pseudo color map 3 colors focal points distributed into 3 levels, level 1 blue（20~40 ms）, level 2 green（41-60 ms）, level 3 red（61~80 ms）. Results T2-mapping indicate the patellar cartilage was abnormal in 78 cases with total of 89 lesions, by classification on T2-mapping pseudo color map, 32 cases in level 1 lesions, 48 cases in level 2 lesions, 9 cases in level 3 lesions. Forty-five lesions in T2-mapping could always be found on PDWI, accounted for 50.6%, but the T2-mapping showed that the depth and width was greater than PDWI. Forty-four lesions were found on T2-mapping, accounted for 49.4%, of which there was 30 level 1 lesions, accounted for 34%, 14 cases in level 2lesions, accounting for 16%. Nine cases in level 3 lesions can also found on T2-mapping and PDWI, shows the depth and width were basically the same. Conclusion T2-mapping imaging can be found by measuring the T2 relaxation time that there no obvious morphological change of early damage of patellar cartilage tissue elements change, thus ef-fectively guiding clinical early diagnosis and treatment, prevent the cartilage irreversible damage, ensure soldiers fighting has important military and clinical value.

关 键 词：膝关节 损伤 髌软骨 磁共振成像 T2图 

分 类 号：R445.2[医药卫生—影像医学与核医学] R82[医药卫生—诊断学]