应用T_(2)^(*)mapping评价不同落地模式对业余马拉松运动员跑步后膝关节软骨的急性影响  

Application of T_(2)^(*) mapping to evaluate the acute effects of different foot-strike patterns on knee cartilage after running in amateur marathon runners

作　　者：王乐[1] 孟凡晶 周静 姚婉贞 张晏镜 戴思宇 毛俊杰 陈勇[2] 刘杰[2] 丁建平[2] Wang Le;Meng Fanjing;Zhou Jing;Yao Wanzhen;Zhang Yanjing;Dai Siyu;Mao Junjie;Chen Yong;Liu Jie;Ding Jianping(Department of Radiology,Affiliated Hospital of Hangzhou Normal University,School of Clinical Medicine,Hangzhou Normal University,Hangzhou 310015,China;Department of Radiology,Affiliated Hospital of Hangzhou Normal University,Hangzhou Marathon Sports Medicine Research Institute,Hangzhou 310015,China;School of Physical Education,Hangzhou Normal University,Hangzhou 310000,China)

机构地区：[1]杭州师范大学附属医院放射科、杭州师范大学临床学院,杭州310015 [2]杭州师范大学附属医院放射科、杭州市马拉松运动医学研究所,杭州310015 [3]杭州师范大学体育学院,杭州310000

出　　处：《中华放射学杂志》2023年第12期1296-1304,共9页Chinese Journal of Radiology

基　　金：浙江省自然科学基金(GF21H180014);浙江省医药卫生科技计划项目(2022KY962);杭州市医药卫生科技项目(A20200360,20211231Y029);杭州市生物医药和健康产业发展扶持科技专项(2021WJCY053)杭州市运动医学重点学科(YDYX)。

摘　　要：目的采用T_(2)^(*)mapping技术评价不同落地模式对业余马拉松运动员跑步后膝关节软骨的急性影响。方法2021年11月至2022年2月在杭州市招募29名业余马拉松运动员,进行步态分析以确定其落地模式,分为前足落地模式(FFS)组(11例)和后足落地模式(RFS)组(18例)。于跑前和跑步30 min后对优势腿膝关节进行MR扫描,测量膝关节软骨各分区的体积、厚度及T_(2)^(*)值,采用独立样本t检验比较组间跑步前基线资料的差异,采用配对样本t检验比较组内跑步前后的差异。结果跑前FFS组与RFS组膝关节软骨体积及厚度差异无统计学意义(P>0.05),RFS组股骨内侧后部T_(2)^(*)值高于FFS组(t=-2.47,P=0.020)。与跑步前比较,FFS组中跑步后胫骨外侧后部软骨厚度减小(t=-2.96,P=0.016),RFS组中胫骨外侧后部及髌骨外侧中央软骨厚度减小(t=-3.25、-3.02,P=0.004、0.007)。FFS组中跑步后胫骨外侧后部软骨体积减小(t=-2.58,P=0.030),RFS组中髌骨外侧中央软骨体积减小(t=-2.74,P=0.013)。FFS组中跑步前后各区域软骨T_(2)^(*)值差异均无统计学意义(P>0.05),RFS组中股骨内侧后部、股骨滑车中央、股骨滑车外侧、股骨外侧中央、胫骨外侧前部、胫骨内侧后部、胫骨内侧中央及胫骨内侧前部软骨T_(2)^(*)值均减低(P<0.05)。结论FFS跑步后膝关节仅胫骨软骨部分亚区表现形态和生化成分的变化,RFS跑步后股骨软骨、髌骨软骨及胫骨软骨大部分区域软骨发生改变,RFS对膝关节软骨急性影响更大。Objective To evaluate the acute effects of different foot-strike patterns of running on knee cartilage in amateur marathon runners using the T_(2)^(*)mapping technique.Methods From November 2021 to February 2022,29 amateur marathon runners were recruited in Hangzhou.The gait analysis was performed to determine their landing patterns,then the runners were divided into the fore-foot strike(FFS)group(11 cases)and the rear-foot strike(RFS)group(18 cases).The MRI of the knee joint of the dominant leg was performed before and 30 min after running,and the volume,thickness,and T_(2)^(*)value of each division of knee cartilage were measured.Independent samples t-tests were used to compare the differences in baseline data before running between the groups,and paired samples t-tests were used to compare the differences before and after running within the groups.Results The difference in knee cartilage volume and thickness between the FFS and RFS groups before running was not statistically significant(P>0.05),and the T_(2)^(*)value of the femur medial posterior in the RFS group was higher than that of the FFS group(t=-2.47,P=0.020).Compared with pre-running,cartilage thickness of the tibia lateral posterior decreased in the FFS group after running(t=-2.96,P=0.016),and cartilage thickness of the tibia lateral posterior and patella lateral central decreased in the RFS group(t=-3.25,-3.02,P=0.004,0.007).Cartilage volume of the tibia lateral posterior decreased in the FFS group after running(t=-2.58,P=0.030),and the cartilage volume of the patella lateral central decreased in the RFS group(t=-2.74,P=0.013).The differences in T_(2)^(*)values of cartilage in each region before and after running were not statistically significant in the FFS group(P>0.05),whereas in the RFS group,the cartilage T_(2)^(*)values in the femur medial posterior,femoral trochanter central,femoral trochanter lateral,femur lateral central,tibia lateral anterior,tibia medial posterior,tibia medial central,and tibia medial anterior decreased(P<0.05).Conclusion

关 键 词：磁共振成像 马拉松 落地模式 膝关节软骨 

分 类 号：R87[医药卫生—运动医学] R445.2[医药卫生—临床医学]