联合应用MRI水激励成像与扩散张量成像早期诊断膝关节软骨损伤  

Combined use of magnetic resonance T2-me3d-we and DTI imaging in early diagnosis of articular cartilage injury of knee

作　　者：郏潜新[1] 卫雍绩[2] 罗爱芳[1] 欧阳林[1] 肖玉辉[1] 罗锦川 汤奕林 蔡阿惠 JIA Qian-xin;WEI Yong-ji;LUO Ai-fang;OUYANG Lin;XIAO Yu-hui;LUO Jin-chuan(TANG Yi-lin,CAI A-hui ＊Department of Medical Image,the 175th Hospital of PLA,Zhangzhou,Fujian 363000,China)

机构地区：[1]解放军第175医院医学影像科,福建漳州363000 [2]国家体育总局运动医学研究所运动医学科

出　　处：《中国骨与关节损伤杂志》2018年第8期809-812,共4页Chinese Journal of Bone and Joint Injury

基　　金：国家体育总局科技项目(2016HT036)

摘　　要：目的探讨联合应用MRI水激励成像(T2-me3d-we)与扩散张量成像(DTI)早期诊断膝关节软骨损伤的价值。方法纳入自2014-01—2017-06经关节镜检查证实50例(55膝)膝关节软骨损伤,术前均进行MRI检查,将T2-me3dwe与DTI图像传至后处理工作站,以T2-me3d-we图像为解剖定位图,观察该序列上膝关节软骨损伤区域,测量该区域的FA值、ADC值。结果 55个膝关节内共发现软骨损伤72处,关节镜下明确膝关节软骨损伤Recht分级:Ⅰ级16处,Ⅱ级22处,Ⅲ级24处,Ⅳ级10处。T2-me3d-we序列检查结果与关节镜检查结果的一致性高于FS-SE-T2WI序列。膝关节软骨损伤处ADC值明显高于正常膝关节软骨,差异有统计学意义(P<0.05)。膝关节软骨损伤部位FA值与Recht分级呈负相关(r=-0.68,P<0.01),膝关节软骨损伤部位ADC值与Recht分级呈正相关(r=0.72,P<0.01)。结论 T2-me3d-we联合DTI成像可以在形态学基础上量化评估膝关节软骨损伤,指导临床根据患者软骨损伤分级情况给予相应干预,避免软骨损伤进一步加重。Objective To investigate the value of magnetic resonance T2-me3d-we and diffusion tensor imaging （DT1） in early diagnosis of articular cartilage injury. Methods The MRI characteristics of 55 knees of 50 patients with articular cartilage injuries from January 2014 to June 2017 were analyzed retrospectively and compared with those of arthroscopy. The MRI scanning methods included DTI and T2-me3d-we. Using T2-me3d-we image as anatomical location map, the cartilage injury area of the knee joint was observed and the FA value and ADC value of the cartilage injury area were measured. Results Seventy-two cartilage injury lesions were verified by the arthroscope in 55 knee joints of these 50 patients. In these lesions, grade I accounted for 22.2% （16/72）, grade ]I 30.5% （22/72）, grade III 33.3% （24/72）, grade IV 13.9% （10/72）. The consistency between T2-me3d-we sequence and arthroscopy was higher than that of FS-SE-T2WI sequence. The mean value of ADC of the injured cartilage was significantly higher than that of normal cartilage, with statistical significance （P 〈0.05）. There was a negative correlation between FA value and Recht classification （r =-0.68, P 〈0.01）. There was a positive correlation between ADC value and Recht classification （r =0.72, P 〈0.01）. Conclusion MRI 3D-DSEE combined with DTI can early detect and classify articular cartilage injuries, and guide early intervention to avoid aggravation of the injury.

关 键 词：膝关节 软骨损伤 核磁共振 水激励成像 扩散张量成像 

分 类 号：R684.7[医药卫生—骨科学]