3D-T1-VIBE评价膝关节纤维蛋白凝胶型自体软骨细胞移植术后软骨修复  

3D-T1-VIBE in evaluating cartilage repair after fibrin matrix-mixed gel-type autologous chondrocyte implantation of the knee

作　　者：马巧稚 张仲文 刘腾腾 郑乔元 姚敏敏 穆学涛 MA Qiaozhi;ZHANG Zhongwen;LIU Tengteng;ZHENG Qiaoyuan;YAO Minmin;MU Xuetao(Department of MR,the Third Medical Centre,Chinese People's Liberation Army General Hospital,Beijing 100039,China;Department of the 4th Orthopedics,the Third Medical Centre,Chinese People's Liberation Army General Hospital,Beijing 100039,China)

机构地区：[1]中国人民解放军总医院第三医学中心磁共振科,北京100039 [2]中国人民解放军总医院第三医学中心骨四科,北京100039

出　　处：《中国医学影像技术》2020年第2期271-275,共5页Chinese Journal of Medical Imaging Technology

基　　金：解放军总医院第三医学中心科研基金(WZ2017022)

摘　　要：目的探讨T1加权三维梯度回波容积内插屏气呼吸检查(3D-T1-VIBE)序列评估纤维蛋白凝胶型自体软骨细胞移植(G-ACI)术后修复软骨的价值。方法 10例男性单侧膝关节软骨运动损伤患者接受G-ACI术。分别于术后1、3、6个月行MR检查,包括常规序列及3D-T1-VIBE序列扫描;采用软骨修复组织磁共振观察(MOCART)评分系统比较术后不同时间"软骨缺损修复填充程度"等9项指标,分析MOCART整体评分与临床膝关节损伤和骨关节炎评分(KOOS)结果的相关性。结果术后1、3、6个月MOCART评分中,"软骨缺损修复填充程度"及整体评分结果存在差异(P均<0.01);术后6个月,"修复组织与相邻正常软骨的融合""修复组织表面结构""软骨信号强度"及"粘连"情况较前好转(P均<0.05)。术后3、6个月,MOCART评分中"修复组织表面结构""软骨缺损修复填充程度"与临床KOOS评分呈正相关(P均<0.05)。结论结合常规序列,MR 3D-T1-VIBE序列扫描能较准确评估G-ACI术后软骨修复情况,且与临床症状存在相关性。Objective To explore the value of 3 D T1-weighted gradient-echo imaging volume tricinterpolated breath-hold examination(3 D-T1-VIBE) in evaluation on cartilage repair after fibrin matrix-mixed gel-type autologous chondrocyte implantation(G-ACI) of the knee. Methods MR scannings of the knees were performed 1, 3 and 6 months post operation in 10 knee cartilage injury patients after G-ACI, including conventional sequences and 3 D-T1-VIBE sequence. Magnetic resonance observation of cartilage repair tissue(MOCART) system was adopted for image presentation, and 9 observation indicators of MOCART overall scoring system in different time after operation were compared. Knee injury and osteoarthritis score(KOOS) was used in clinical practice. And correlation analysis was performed between KOOS and MOCART. Results One, 3 and 6 months after G-ACI, significant differences of "cartilage defect repair filling degree" and MOCART total grouping were found(all P<0.01). Six months after G-ACI, "reconstruction of tissue and adjacent normal cartilage", "repair of tissue surface structure", "chondral signal intensity" and "with or without adhesion" were better than that before operation(all P<0.05). Three and 6 months after G-ACI, "repaired tissue surface structure" and "cartilage defect repair filling degree" were positively correlated with KOOS score(all P<0.05). Conclusion 3 D-T1-VIBE combined conventional MR sequences can accurately evaluate cartilage repair after G-ACI, and have certain correlation with clinical symptoms.

关 键 词：软骨 纤维蛋白凝胶型自体软骨细胞移植 磁共振成像 

分 类 号：R658.3[医药卫生—外科学] R445.2[医药卫生—临床医学]