软骨多参数磁共振成像评估脂肪间充质祖细胞治疗膝骨关节炎效果的价值  

Value of multi-parameter magnetic resonance imaging of cartilage in evaluating efficacy of adiposederived mesenchymal progenitor cells on knee osteoarthritis

作　　者：阮晶晶 路青[2] 唐辉[2] 朱震娅 范瑜[2] 赵欣欣 钮晓音[1] RUAN Jing-jing;LU Qing;TANG Hui;ZHU Zhen-ya;FAN Yu;ZHAO Xin-xin;NIU Xiao-yin(Shanghai Jiao Tong University School of Medicine,Shanghai Institute of Immunology,Shanghai 200025,China;Department of Radiology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院,上海市免疫学研究所,上海200025 [2]上海交通大学医学院附属仁济医院放射科,上海200127

出　　处：《上海交通大学学报（医学版）》2019年第12期1409-1415,共7页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(81871269);上海市卫生和计划生育委员会科研课题面上项目(201640137)~~

摘　　要：目的·分析膝关节软骨多参数磁共振成像(magnetic resonance imaging,MRI)在评估异体人源脂肪间充质祖细胞(human adipose-derived mesenchymal progenitor cells,haMPCs)治疗骨关节炎效果中的价值。方法·对22例膝骨关节炎受试者给予haMPCs治疗,根据给药剂量随机分为低、中和高3个剂量组。在治疗前及治疗后第48周分别对治疗膝关节进行西安大略大学和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC)评分和软骨多参数MRI扫描(3DSPGR、T2-mapping、T2^*-mapping、T1ρ-mapping和DWI),测量并记录治疗前后受试者WOMAC评分、软骨体积、T2值、T2^*值、T1ρ值与表现扩散系数(apparent diffusion coefficient,ADC)值,比较治疗前后及不同剂量组间这些评估指标的变化。结果·18例受试者完成了WOMAC评分及2次MRI检查。治疗后,除软骨体积外,所有受试者WOMAC评分、T2值、T2^*值、T1ρ值及ADC值与治疗前均存在显著差异(P<0.05)。各剂量组治疗前后比较显示:WOMAC评分、T2^*值及T1ρ值在3个剂量组均可见显著性改变(P<0.05);T2值在中、高剂量组可见显著性改变(P<0.05);ADC值仅在高剂量组发生显著变化(P=0.026);而软骨体积未见显著性变化(P>0.05)。进一步组间比较显示:治疗前各评估指标均无显著差异(P>0.05);治疗后仅高剂量组与低剂量组间受试者软骨T1ρ值存在显著差异(P=0.012)。结论·多参数软骨MRI组织成分成像可用于评估haMPCs治疗骨关节炎的效果,较软骨体积评估可能更敏感。Objective·To analyze the value of multi-parametric magnetic resonance imaging(MRI)of knee cartilage in evaluating the efficacy of allogeneic human adipose-derived mesenchymal progenitor cells(haMPCs)on the treatment of osteoarthritis.Methods·Twenty-two patients with knee osteoarthritis were treated with haMPCs and randomly divided into three dose groups,low,medium and high,according to the medication dose.Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score and carotid multi-parametric MRI scans which include 3D-SPGR,T2-mapping,T2^*-mapping,T1ρ-mapping and DWI were performed before and after 48 weeks’treatment.The WOMAC score,cartilage volume,T2 value,T2^* value,T1ρvalue and apparent diffusion coefficient(ADC)value were recorded.The index changes and the inter-group differences were compared.Results·A total of 18 candidates completed the WOMAC score evaluations and MRI examinations twice.After treatment,except for cartilage volume,WOMAC score,T2 value,T2^*value,T1ρvalue and ADC value of all subjects were significantly different from those before treatment(P<0.05).WOMAC score,T2^* value and T1ρvalue were significantly changed in all groups(P<0.05),and T2 value was significantly changed in the medium dose group and high dose group(P<0.05).ADC value was significantly changed in the high dose group(P=0.026)while there was no significant changes in cartilage volume(P>0.05).The inter-group comparisons showed that there was no significant difference before treatment(P>0.05),but there was a significant difference of T1ρin cartilage between the high-dose group and the low-dose group(P=0.012)after treatment.Conclusion·Multi-parametric cartilage MRI can be used to evaluate the efficacy of haMPCs treatment on osteoarthritis,which may be more sensitive than cartilage volume assessment.

关 键 词：膝骨关节炎 磁共振成像 间充质祖细胞 

分 类 号：R684.3[医药卫生—骨科学]