MRI 3D-FS-SPGR序列延迟增强诊断初期膝关节软骨损伤  

Delayed gadolinium-enhanced 3D-FS-SPGR MRI squence of cartilage in the diagnoses of early injury of knee articular cartilage

作　　者：蓝燚锋 叶艺先 马云彪[1] 范淑玉[1] 吕永章 LAN Yifeng;YE Yixian;MA Yunbiao;FAN Shuyu;LYU Yongzhang(Department of Radiology,Nanhai District Sixth People＇s Hospital,Foshan 528248,P.R.China)

机构地区：[1]广东省佛山市南海区第六人民医院放射科,广东佛山528248

出　　处：《医学影像学杂志》2018年第11期1918-1922,共5页Journal of Medical Imaging

基　　金：广东省佛山市医学类科技攻关项目(编号:2016AB000822)

摘　　要：目的探讨MRI 3D-FS-SPGR序列延迟增强诊断膝关节软骨初期损伤的可行性和价值。方法选取45例经关节镜诊断为初期膝关节软骨损伤患者,先3D-FS-SPGR序列平扫,静脉注入钆对比剂后平地活动10 min,让钆剂尽量扩散至软骨中,2h后再作3D-FS-SPGR扫描,检查结论同关节镜所见对照。另外挑选3例健康志愿者检查作为对照组。结果 3D-FS-SPGR序列上健康膝关节软骨为光滑、弧形高信号,并可见由表至里的高-中-高3层信号;初期损伤的软骨变薄,病损区在3D-FS-SPGR平扫上呈低信号,在延迟增强序列上呈高信号且范围增大,软骨下骨髓水肿也呈高信号。3D-FS-SPGR平扫显示Ⅰ期软骨损伤的符合率为38. 1%(8/21),显示Ⅱ期软骨损伤的符合率为50%(12/24);延迟增强显示Ⅰ期软骨损伤的符合率为76. 2%(16/21),显示Ⅱ期软骨损伤的符合率为87. 5%(21/24)。经t检验,延迟增强显示膝关节软骨Ⅰ、Ⅱ期损伤的符合率明显优于平扫(Ⅰ期t=2. 961,P=0. 008;Ⅱ期t=2. 840,P=0. 009)。结论 MRI 3D-FS-SPGR延迟增强显示膝关节软骨初期损伤优于平扫,检出率高于关节镜,可为临床提供更多关于初期软骨损伤的信息。Objective To explore the feasibility and the value of delayed gadolinium-enhanced MRI of cartilage （dGEMRIC） using 3D-FS-SPGR squence in diagnosing early knee cartilage injury. Methods 45 patients with patellae chondromalacia at early stage first underwent 3D-FS-SPGR series plain scan, the patients were required to walk for 10 min to make the contrast agent disperse into the cartilage after intravenous injection of gadolinium acid. Then patients underwent dGEMRIC scan 2 hours later. The results of the examination and the arthroscopy were compared. In addition, 3 healthy volunteers were selected as control group. Results The normal knee cartilage in the 3D-FS-SPGR series was a smooth curved band with high signal, with a high, low and high signal three-layer structure. Initially damaged was cartilage thinning. Early cartilage damage was relatively low signal in 3D-FS-SPGR. High signal and range increased in delayed enhancement sequence. Bone marrow edema under cartilage also showed high signal. The t test showed that the coincidence rate of the delayed enhanced scan of the articular cartilage of the knee joint was significantly higher than that of the plain scan （ t =2.961, P =0.008 in stageⅠ; t =2.840, P =0.009 in stage Ⅱ）. Conclusion MRI 3D-FS-SPGR delayed enhancement showed that early injury of knee cartilage was better than that of plain sweep. The detection rate was higher than that of arthroscopy, which can provide more information about the initial cartilage injury.

关 键 词：磁共振成像 延迟增强扫描 软骨损伤 膝关节 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.3[医药卫生—诊断学]