基质诱导的自体软骨细胞移植术的磁共振成像评估及其与软骨下骨的相关性  

MRI results of matrix-induced autologous chondrocyte implantation of the knee and correlation analysis with subchondral bone

作　　者：吕嘉玲[1] 林伟强 张隐笛 李顶夫[1] 雷益[1] 王玉理[1] 何文杰 朱伟民[2] 陈康[2] LV Jialing;LIN Weiqiang;ZHANG Yindi;LI Dingfu;LEI Yi;WANG Yuli;HE Wenjie;ZHU Weimin;CHEN Kang(Department of Medical Imaging,the First Affliated Hospital of Shenzhen University,Shenzhen Second People's Hospital,Shenzhen 518035,China;Department of Sports Medicine,the First Affliated Hospital of Shenzhen University,Shenzhen Second People's Hospital,Shenzhen 518035,China)

机构地区：[1]深圳大学第一附属医院深圳市第二人民医院医学影像科,广东深圳518035 [2]深圳大学第一附属医院深圳市第二人民医院运动医学科,广东深圳518035

出　　处：《实用放射学杂志》2020年第5期776-779,共4页Journal of Practical Radiology

基　　金：深圳市卫生计生系统科研项目(SZFZ2018061).

摘　　要：目的探讨基质诱导的自体软骨细胞移植(MACI)治疗股骨滑车大面积软骨损伤的疗效以及初步探讨移植物预后是否与软骨下骨的质量相关.方法选取接受MACI手术的30例患者进行随访;用Lysholm评分及国际膝关节文献编制委员会分级评估标准(IKDC)评分问卷行膝关节主观功能评估,在术前及术后进行;软骨移植物的MR结果采用软骨修复组织MR观察(MOCART)评分及T2?值表示.采用两配对样本的t检验评估术前、术后Lysholm评分、IKDC的均值差异;采用Mann-Whitney U检验比较分析2组患者术区软骨移植物与术区旁6 mm区域T2?值的差异;采用Pearson检验分析软骨下骨的受损面积与移植物MOCART评分、T2?值评分的相关性.结果30例患者术前、术后Lysholm评分为58.92±6.41、90.15±5.66(P<0.01),IKDC评分术前、术后为56.23±7.81、93.22±5.51(P<0.01);软骨移植物MOCART评分为(61.63±18.47)分;软骨下骨的受损面积与移植物的MOCART评分、T2?值有显著的负相关(r=-0.70,P<0.01;r=-0.71,P<0.01);结论MACI对Ⅲ~Ⅳ°大面积软骨损伤有较好的近期疗效,可显著改善膝关节功能;软骨下骨的受损面积与移植物的MOCART评分及T2?值呈显著负相关,对移植物的预后起着重要的作用.Objective To evaluate the efficacy of matrix induced autologous chondrocyte implantation(MACI)for the femoral trochlear cartilage injury and to evaluate whether graft was associated with subchondral bone quality.Methods 30 patients who underwent MACI surgery were selected.International Knee Documentation Comittee(IKDC)and Lysholm score were ollcted to assess the clinical function,preoperation and postoperation.MR observation of cartilage grafts based on magnetic resonance observation of cartilage repair tissue(MOCART),at the same time,the T2^*-relaxation time was obtained by measurement.Paried t-test was used to compare the Lysholm and IKDC scores preoperation and postoperation;Manr Whitney U test was used to compare T2^*-relaxation time of cartilage repair tissue and control area;Peurson tests were used to correlations.Resuts In our study,L.ysbolm score was significantly increased to(90.15±5.66)compare to preoperative one(58.92±6.41)(P<0.01),IKDC score was significantly increased to(93.22±5.51)compare to preoperative one(56.23±7.81)(P<0.01);MOCART was(61.63±18.47).MOCART and T2^*-relaxation time of cartilage repair tissue was significantly negatively correlated with the quality of the subchondral bone(r=-0.70,P<0.01;r=-0.71,P<0.01)..Concusion MACI is an efctive treatment for patients with large defection Ⅲ-Ⅳ° cartilage injury.The lesion area of the subchondral bone is significantly negatively correlated with the MOCART score and T2^*-relaxation time of the graft,and plays an important role in the outcome of the graft.

关 键 词：自体软骨细胞移植 软骨下骨 磁共振成像 

分 类 号：R681.3[医药卫生—骨科学] R445.2[医药卫生—外科学]