超短回波时间磁化传递技术在业余马拉松运动员髌前肌腱动态监测中的应用  

Monitoring changes of anterior patellar tendon in amateur marathon athletes using ultra-short echo time magnetization transfer technology

作　　者：朱诞恬 方义杰 吴文浩[1] 俞文君 马亚军 李绍林[1] Zhu Dantian;Fang Yijie;Wu Wenhao;Yu Wenjun;Ma Yajun;Li Shaolin(Department of Radiology,Fifth Affiliated Hospital,Sun Yat-Sen University,Zhuhai 519000,China;Department of Radiology,University of California,San Diego,San Diego 92103,USA)

机构地区：[1]中山大学附属第五医院影像医学部放射科,珠海519000 [2]美国加利福尼亚大学圣地亚哥分校放射科,圣地亚哥92103

出　　处：《中华放射学杂志》2023年第12期1284-1289,共6页Chinese Journal of Radiology

基　　金：国家自然科学基金(82101995,82172053)。

摘　　要：目的探讨超短回波时间磁化传递(UTE-MT)技术定量动态监测业余马拉松运动员比赛前后髌前肌腱(髌腱、股四头肌肌腱)改变的价值。方法2020年10月至2021年1月间前瞻性招募珠海市23名业余马拉松运动员,年龄28~50(40±6)岁。分别于马拉松赛前、赛后48 h、赛后4周行双侧膝关节三维UTE-MT和双回波UTE-T_(2)^(*)序列扫描。另招募非跑步志愿者5名,用于验证序列的稳定性。由2名放射科医师独立在膝关节矢状面图像上测量髌腱、股四头肌肌腱以及3个骨腱插入点(髌腱-胫骨插入点、髌腱-髌骨插入点、股四头肌肌腱-髌骨插入点)的UTE-磁化传递率(MTR)和UTE-T_(2)^(*)值。用双向混合类内相关系数(ICC)评估2个序列测值的稳定性和2名放射科医师的一致性。采用重复测量方差分析比较马拉松赛前后髌前肌腱UTE-MTR、UTE-T_(2)^(*)值的差异。结果UTE-MT和双回波UTE-T_(2)^(*)序列测量值均具有很好的稳定性,ICC值分别为0.98和0.92。2名放射科医师对髌腱、股四头肌肌腱和3个骨腱插入点的UTE-MTR、UTE-T_(2)^(*)值测量的一致性好,ICC均>0.80。马拉松赛后48 h髌腱、股四头肌肌腱、3个骨腱插入点的UTE-MTR值降低,赛后4周髌腱的MTR值持续下降,其他区域的UTE-MTR增高。仅髌腱的UTE-MTR在马拉松赛前(0.34±0.04)、赛后48 h(0.32±0.04)、赛后4周(0.31±0.04)间差异有统计学意义(F=7.46,P=0.001)。各区域的UTE-T_(2)^(*)值在马拉松赛后48 h均轻度升高,但3个时间点间差异均无统计学意义(P>0.05)。结论UTE-MT的序列稳定性和测量一致性均较好。UTE-MT技术可用于监测马拉松运动前后髌前肌腱的动态变化,髌腱的UTE-MTR在马拉松运动后下降。Objective To explore the value of ultra-short echo time magnetization transfer(UTE-MT)techniques for quantitatively dynamic monitoring of anterior patellar tendon(patellar tendon,quadriceps tendon)changes in amateur marathon runners before and after competition.Methods Between October 2020 and January 2021,23 amateur marathoners in Zhuhai,aged 28-50(40±6)years,were prospectively recruited.Three-dimensional UTE-MT and dual-echo UTE-T_(2)^(*)sequence scans of bilateral knee joints were performed before,48 hours and 4 weeks after the marathon running,respectively.Another 5 non-running volunteers were recruited for verification of sequence stability.UTE-magnetization transfer ratio(MTR)and UTE-T_(2)^(*)value of the patellar tendon,quadriceps tendon,and 3 tendon-bone insertion points(patellar tendon-tibial insertion point,patellar tendon-patellar insertion point,and quadriceps tendon-patellar insertion point)were measured independently on sagittal images of the knee joint by 2 radiologists.The stability of the 2 serial measurements and consistency tests between the 2 radiologists were assessed with a two-way mixed intraclass correlation coefficient(ICC).Repeated-measures analysis of variance was used to compare the differences in UTE-MTR and UTE-T_(2)^(*)values of the prepatellar tendon before and after the marathon running.Results Both UTE-MT and dual-echo UTE-T_(2)^(*)sequence measurements had good stability,with ICC values of 0.98 and 0.92,respectively.Measurements of UTE-MTR and UTE-T_(2)^(*)value of the patellar tendon,quadriceps tendon,and the 3 tendon-bone insertion points by the 2 radiologists were in good agreement(ICC>0.80).Forty-eight hours after the marathon running,the UTE-MTR of the patellar tendon,quadriceps tendon,and the 3 tendon-bone insertion points decreased,and UTE-MTR of the patellar tendon continued to decrease 4 weeks after the race,while UTE-MTR of other regions increased.Only the difference in UTE-MTR for the patellar tendon was statistically significant(F=7.46,P=0.001)among pre-marathon(0.3

关 键 词：磁共振成像 超短回波时间 髌前肌腱 马拉松 

分 类 号：R873[医药卫生—运动医学] R445.2[医药卫生—临床医学]