磁共振成像T2-mapping与3D-SPACE序列评估国际骨循环研究协会分期中2期及3A期股骨头坏死软骨损伤的差异性研究  

Study on the difference of MRI T2mapping and MRI 3D-SPACE sequence in assessing cartilage injury of femoral head necrosis at stage 2,stage 3A as the ARCO staging

作　　者：史珊[1] 谢利民[2] 方继良[1] 于潼[2] 杨学东[1] 洪洋[1] SHI Shan;XIE Li-min;FANG Ji-liang(Department of Radiology,Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院放射科,北京100053 [2]中国中医科学院广安门医院骨科,北京100053

出　　处：《中国医学装备》2023年第5期72-76,共5页China Medical Equipment

基　　金：北京联影智能影像技术研究院基金(CRIBJQY202109)“利用计算机深度学习技术提高X线平片诊断早期股骨头缺血坏死准确性的研究”;中国中医科学院科技创新工程项目(CI2021A03302、CI2021A03320)“基于CT影像组学及深度学习法对健脾补肾方治疗ARCO 2、3期股骨头缺血坏死疗效的早期预测及评估的研究;基于CT定量测量及有限元模型分析中医体质对股骨头坏死塌陷影响的力学机制研究”。

摘　　要：目的:探讨T_(2)-mapping与三维可变翻转角快速自旋回波(3D-SPACE)序列磁共振成像(MRI)评估国际骨循环研究协会(ARCO)分期中ARCO 2期、ARCO3A期股骨头软骨损伤的差异。方法:选取就诊于医院的23例ARCO 2期和3A期股骨头坏死患者,将其分别纳入ARCO 2期组和3A期组,另选7名正常志愿者纳入正常对照组,3组均行T_(2)-mapping及3D-SPACEMRI成像,并进行髋关节Harris评分;通过Siemens后处理工作站计算定量参数T_(2)值,并勾画感兴趣区域(ROI)进行测量;在医学图像存储与传输系统(PACS)工作站基于3D-SPACE序列采用半定量评分对软骨形态变化进行评估。比较ARCO 2期组、ARCO3A期组患者股骨头软骨T_(2)值及软骨半定量评分与正常对照组的差异,并分析T_(2)值、半定量评分与Harris评分的相关性。结果:T_(2)值比较:ARCO 2期组与正常对照组相比差异无统计学意义;ARCO3A期分别与ARCO 2期及正常对照组比较,T_(2)值差异有统计学意义(F=6.879,P<0.05)。软骨半定量评分比较:ARCO3A期组与ARCO 2期组、正常对照组相比较,差异均有统计学意义(F=9.058,P<0.05)。相关性分析:ARCO 2期和3A期患者股骨头软骨T_(2)值与软骨半定量评分无相关性;T_(2)值与Harris评分无相关性;软骨半定量评分与Harris评分呈负相关(r=-0.53,P<0.01)。结论:ARCO 2期的T_(2)-mapping及3D-SPACE序列成像均未发现软骨损伤,ARCO 2期可不行软骨损伤评估;T_(2)-mapping及3D-SPACE序列成像均可用于ARCO3A期软骨损伤的评估,3D-SPACE序列可评估软骨形态的变化,且与Harris评分相关,ARCO3A期可行3D-SPACE序列MRI检查。Objective:To explore the difference between T_(2) mapping and three dimensional-sampling perfection with application optimized contrast using different flip angle evolutions(3D-SPACE)of magnetic resonance imaging(MRI)in assessing cartilage injury of femoral head necrosis(FHN)at the stage 2 and stage 3A as the staging of Association Research Circulation Osseous(ARCO).Methods:Twenty-three patients with FHN at ARCO stage 2 and 3A were selected and they were included in ARCO stage 2 group and stage 3A group respectively according to the results of ARCO staging,and other 7 normal volunteers were included in normal control group.All of the three groups underwent MRI T_(2)-mapping and MRI 3D-SPACE,and Harris scoring on hip joint.The Siemens post processing workstation was adopted to calculate T_(2) value of quantitative parameters,and to outline the region of interesting(ROI)so as to conduct measurement.The medical picture archiving and communication system(PACS)adopted semi-quantitative scoring to assess the change of cartilage morphology based on 3D-SPACE.The differences of T_(2) value of femoral head cartilage and the semi-quantitative score of cartilage among ARCO stage 2 group,ARCO stage 3A group and normal control group were compared,and then the correlations among T_(2) value,semi-quantitative score and Harris score were further and normal control group,and the difference of that between ARCO stage 3A and ARCO stage 2,between ARCO stage 3A and normal control group were significant(F=6.879,P<0.05).For the comparison about semi-quantitative score of cartilage:there were significant differences among the ARCO stage 3A,the ARCO stage 2 and normal control group(F=9.058,P<0.05).The results of correlation analysis indicated that there were no significant correlation between T_(2) value and semi-quantitative score of cartilage in patients at ARCO stage 2 and ARCO stage 3A,and T_(2) value had no significant correlation with the Harris score,and the semi-quantitative score of cartilage was negatively correlated with Harris

关 键 词：股骨头坏死 软骨损伤 T2-mapping 3D-SPACE HARRIS评分 

分 类 号：R445.2[医药卫生—影像医学与核医学]