表观扩散系数值在膝关节骨挫伤与骨性关节炎骨髓病灶中的应用价值  

Comparative study of apparent diffusion coefficient values of bone marrow lesions between bone contusions and osteoarthritis in the knee

作　　者：何伟欣 宋玲玲 曾琪 朱霞 黄曌殊 张紫微 眭贺 HE Weixin;SONG Lingling;ZENG Qi;ZHU Xia;HUANG Zhaoshu;ZHAGN Ziwei;SUI He(Department of Imaging,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China)

机构地区：[1]贵州医科大学附属医院影像科,贵州贵阳550004

出　　处：《实用放射学杂志》2022年第2期289-292,共4页Journal of Practical Radiology

基　　金：贵州省科学技术厅联合资金项目(LH字[2016]7259)号.

摘　　要：目的探讨运用扩散加权成像(DWI)的表观扩散系数(ADC)值评估骨挫伤、骨性关节炎(OA)患者骨髓病灶的价值.方法具有确切膝关节外伤史且病史≤3个月、MRI平扫结果符合骨挫伤影像学表现的患者17例(骨挫伤组),符合膝OA临床表现及影像学表现且MRI平扫能检出确切骨髓病灶的患者44例(OA组),招募正常志愿者62例(对照组).应用GE Discovery 750W 3.0T MR成像系统对患者患侧及志愿者的任意一侧膝关节进行MRI扫描,将原始数据传至工作站进行后处理,形成伪彩图.勾画骨髓病灶感兴趣区(ROI)并记录ADC值,采用独立样本t检验进行统计学分析.结果骨挫伤组、OA组骨髓病灶的ADC值分别为(0.93±0.22)×10^(-3)mm^(2)/s、(1.14±0.2)×10^(-3)mm^(2)/s,均高于对照组正常骨髓的ADC值(0.21±0.06)×10^(-3)mm^(2)/s,且差异均有显著统计学意义(P<0.01);OA组骨髓病灶的ADC值(1.14±0.2)×10^(-3)mm^(2)/s较骨挫伤组骨髓病灶ADC值更高,差异有显著统计学意义(P<0.01).结论骨挫伤、OA骨髓病灶ADC值均较正常骨髓显著增高,OA骨髓病灶ADC值与骨挫伤骨髓病灶ADC值有显著差异,ADC值可用于二者病变性质的鉴别.Objective To investigate the diagnostic value of apparent diffusion coefficient(ADC)value of diffusion weighted imaging(DWI)in evaluating the bone marrow lesions in bone contusions and osteoarthritis(OA).Methods 17 patients with exact trauma history of the knee(less than 3 months)and MRI scan results of bone contusions were classified as bone contusions group.44 patients with clinical symptoms and imaging findings of knee OA with bone marrow lesions were classified as OA group.62 healthy normal volunteers were classified as control group.The affected side of patients and either side of health volunteers were imaged at 3.0T MR(GE Discovery 750W),the original images were obtained and transmitted to post-processing work station.The region of interest(ROI)of bone marrow lesions were selected and ADC values were calculated.Statistical analysis were performed using independent-sample t test.Results The ADC values of bone contusions group and OA group was(0.93±0.22)×10^(-3)mm^(2)/s and(1.14±0.2)×10^(-3)mm^(2)/s,respectively,both of which were higher than that of control group[(0.21±0.06)×10^(-3)mm^(2)/s],and shared a significant statistical differences(P<0.01).The ADC values of bone marrow lesions in OA group[(1.14±0.2)×10^(-3)mm^(2)/s]were higher than that of bone contusions group,and there was a statistic significance as well(P<0.01).Conclusion The ADC values of bone marrow lesions in bone contusions and OA are higher than that of normal bone marrow.The ADC values between the bone contusions group and OA group are significantly different,which can be used to identify the bone marrow lesions in bone contusions and osteoarthritis.

关 键 词：骨挫伤 骨性关节炎 骨髓 膝关节 表观扩散系数 

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