摘要
目的：研究膝骨关节炎（OA）的软骨磁共振表现（MRI）,评估软骨MR成像对于OA诊疗评估的意义。方法：对56例40~70周岁确诊膝关节OA病例和45例无症状志愿者行X线检查并进行K-L评分后实施软骨MR成像：①快速自旋回波T2加权成像（FSE T2WI）;②三维脂肪抑制扰相梯度回波序列（3D-FS-SPGR）并采用最大信号强度法（MIP）进行三维重建;③脂肪抑制质子加权序列（FS-PD）。分别比较：①软骨平均厚度;②软骨缺损分布区域并进行直径测量和Noyes分级;③软骨下骨质水肿表现,并统计分析两组磁共振表现差异。结果：①OA病例组膝关节X线平片K-L积分显著高于病例组（Z=-5.39481,P〈0.001）;②病例组膝关节软骨整体厚度显著低于对照组（P〈0.001）;③病例组膝关节软骨缺损所涉及的关节面区域多于对照组（Z=-6.23,P〈0.001）;软骨缺损的Noyes分级水平（Z=-8.336,P〈0.001）和软骨缺损直径（Z=-8.42,P〈0.001）也大于对照组。④病例组膝关节出现不同程度的软骨下骨质水肿,而对照组所有膝关节均没有出现软骨下骨质异常信号。结论：40~70岁OA患者的膝关节软骨相对同年龄无症状人群显著变薄,且软骨缺损程度大。结合合适的评价系统,软骨磁共振成像可以有效地应用于OA临床诊断和治疗评估。
Purpose：To study the magnetic resonance imaging（MRI）appearances of osteoarthritis（OA）,and to assess the value of MRI in clinical diagnosis of OA.Methods：Fifty-six cases of 40～70 years old patients confirmed as OA and asymptomatic 45 volunteers were scanned with cartilage MR after the knee X-ray examination by the following sequences： Fast spin echo T2-weighted imaging（FSE T2WI）,3D fat-suppressed spoiled gradient echo sequence（3D-FS-SPGR） with maximum intensity projection reconstruction（MIP）,fat-suppressed proton-weighted sequence（FS-PD）.And the follow results were compared：the average thickness of cartilage,the defect condition of cartilage and subchondral bone edema.The differences between two groups of MRI features were analyzed.Results：On the knee X-ray K-L points of the OA patients were significantly higher than the control group（Z=-5.39481,P〈0.001）.The cartilage average thickness of the patients were significantly lower than the control group（P〈0.001）.Knee articular cartilage defects of the articular surface area involved in the patient group were more than the control group（Z=-6.23,P〈0.001）.The Noyes level and the range of cartilage defects of patients group were significantly higher than the control group（Z=-8.336,P0.001;Z=-8.42,P〈0.001）.In the patient group there were different degrees of knee subchondral bone edema,meanwhile subchondral bone abnormalities in the control group were not observed.Conclusion：The articular cartilage of 40～70 years old patients with knee OA is significantly thinner than the asymptomatic same age group,and the cartilage defects degree of patients group are significantly higher than thecontrol group.With a suitable evaluation system,cartilage magnetic resonance can be effectively used in clinical diagnosis of OA.
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2011年第1期54-58,共5页
Chinese Computed Medical Imaging
基金
上海"创新行动计划"重点项目的基础研究(09jc1409800)
上海交通大学医学工程(技术)研究基金(yg2009ms16)
关键词
膝关节
磁共振成像
关节软骨
骨关节炎
Knee
Magnetic resonance imaging
Articular cartilage
Osteoarthritis
