基于T_(2)mapping及超短回波时间技术定量探究早期膝骨关节炎的发病机制  

Quantitative Exploration of Pathogenesis in Early Knee Osteoarthritis Based on T_(2)Mapping and UTE Techniques

作　　者：牛飞格 孟祥虹 孙曼 王植 NIU Feige;MENG Xianghong;SUN Man(Graduate School of Tianjin Medical Unviersity,Tianjin 300070,P.R.China)

机构地区：[1]天津医科大学研究生院,300070 [2]天津大学天津医院放射科,300202

出　　处：《临床放射学杂志》2025年第2期350-356,共7页Journal of Clinical Radiology

摘　　要：目的基于浅表软骨的T_(2)mapping和骨软骨交界区(OCJ)的超短回波时间(UTE)T_(2)^(*)mapping探究膝骨关节炎(KOA)早期浅表软骨和骨软骨交界区的病变顺序。方法对纳入的30个健康膝和30个早期骨性关节炎膝进行常规和定量MRI扫描,主要扫描序列包括三维水激发序列(3D WATS)、T_(2)mapping和UTE T_(2)^(*)mapping。将每个膝关节都分为股骨内侧髁、股骨外侧髁、胫骨内侧髁、胫骨外侧髁、髌骨和滑车区6个区域并测量每个区域的浅层软骨T_(2)值和OCJ T_(2)^(*)值。用独立样本t检验比较健康组和早期KOA组间的浅层软骨T_(2)值及OCJ T_(2)^(*)值。用Spearman相关性检验评估浅层软骨T_(2)值与OCJ T_(2)^(*)值间的相关性。结果早期KOA组的浅层软骨T_(2)值在股骨内侧髁(P<0.001)、胫骨内侧平台(P<0.001)、髌骨(P<0.001)和股骨滑车区(P=0.01)相对于健康组显著升高。早期KOA组OCJ T_(2)^(*)值在股骨内侧髁(P<0.001)、胫骨内侧平台(P<0.001)、胫骨外侧平台(P<0.001)、髌骨(P=0.001)和滑车区(P<0.001)均显著升高。浅层软骨T_(2)值和骨软骨交界区T_(2)^(*)值间存在正相关关系(r=0.37,P<0.001)。结论浅表软骨的T_(2)mapping和骨软骨交界区的UTE T_(2)^(*)mapping成像都可定量且无创识别早期KOA。在KOA早期,浅表软骨和OCJ都出现了生化改变。Objective To investigate the sequential order of pathological changes occurring in the superficial cartilage and osteochondral junction(OCJ)in early knee osteoarthritis(KOA),based on T_(2)mapping of the superficial cartilage and UTE(ultrashort echo time)-T_(2)^(*)mapping of the OCJ.Methods Conventional and quantitative MRI scans were performed on 30 healthy knees and 30 knees with early osteoarthritis.The main scan sequences included three-dimensional water-selective(3D WATS),T_(2)mapping,and UTE T_(2)^(*)mapping.Each knee joint was divided into 6 regions:medial femoral condyle,lateral femoral condyle,medial tibial plateau,lateral tibial plateau,patellar and trochlear region.The T_(2)values of superficial cartilage and T_(2)^(*)values of OCJ in each region were measured.The superficial cartilage T_(2)values and OCJ T_(2)^(*)values between the healthy group and the early KOA group were compared by independent sample t test.Spearman correlation test was used to evaluate the correlation between T_(2)values of superficial cartilage and T_(2)^(*)values of OCJ.Results The superficial cartilage T_(2)values in the medial femoral condyle(P<0.001),medial tibial plateau(P<0.001),patella(P<0.001)and trochlear(P=0.01)in the early KOA group were significantly higher than those in the healthy group.In early KOA group,OCJ T_(2)^(*)values were significantly increased in medial femoral condyle(P<0.001),medial tibial plateau(P<0.001),lateral tibial plateau(P<0.001),patella(P=0.001)and trochlear(P<0.001).There was a positive correlation between superficial cartilage T_(2)values and OCJ T_(2)^(*)values(r=0.37,P<0.001).Conclusion Both T_(2)mapping of superficial cartilage and UTE T_(2)^(*)mapping of the osteochondral junction can identify early KOA,quantitatively and noninvasively.In the early stage of KOA,both superficial cartilage and OCJ can show biochemical changes.

关 键 词：骨性关节炎 关节软骨骨软骨交界区 T_(2)mapping T_(2)^(*)mapping 

分 类 号：R68[医药卫生—骨科学]