摘要
目的 观察磁共振T2-mapping成 像定量早期诊断膝关节骨性关节炎的临床 效果。方法 选取华东医院确诊并收治的 200例膝关节OA患者设为观察组,均经国 际软骨修复协会分级标准诊断确诊,其中 有男80例,女120例,年龄33-58岁,平均 (47±3.8)岁,共参与膝关节310个;另选 取同期至我院体检的健康者200例,包括 有男75例,女125例,年龄31-57岁,平 均(46±4.1)岁,共参与膝关节315个。 以Siemens 3.0T磁共振作为检查工具, 采用T2-mapping序列检查和测量两组对象 的股骨内外髁负重部位及非负重部位、 胫骨内外平台、髌软骨总计7处软骨的平 均T2值,并测量股骨内外髁负重部位及 非负重部位软骨深浅层的T2值,对比分析 两组对象的T2值。结果 观察组各处软骨 的平均T2值均明显高于对照组,两组的比 较差异有统计学意义(P<0.05);两组对象 股骨内外髁负重部位的软骨T2值均显著高 于非负重部位,比较差异明显,具有统计 学意义(P<0.05)。观察组患者的股骨内外 髁非负重部位软骨浅层T2值明显较深层高 (P<0.05),而负重部位的软骨深浅层T2值 的比较差异则无统计学意义(P>0.05);对 照组健康人员的股骨髁软骨深、浅层的T2 值比较则有显著差异,具有统计学意义 (P<0.05)。对应的T2图释义了T2值的变化 状态。结论 磁共振T2-mapping成像定量 早期诊断膝关节骨性关节炎的临床价值明 确,可及时发现早期OA关节软骨的异常改 变,值得临床推广应用。
Objective To observe the clinical effect of MR T2-mapping imaging analysis diagnosis of knee osteoarthritis (OA). Methods Selected 200 cases of knee OA patients diagnosed and treated in Huadong hospital as the observed group, all conformed to the international cartilage repair society (ICRS) classification standard, including 80 male and 120 female, 33-58 years old, the average was(47±3.8), and participated in the knee joint 310. And selected healthy 200 people with physical examination at the same time to the hospital as the controlled group, including 75 male and female, 31-57 years old, the average was (46±4.1), with 315 knee joint. Used Siemens 3.0 T magnetic resonance (NMR) as test tools,T2 values of seven compartments of knee cartilage including weigh bearing site and non weight bearing site of medial femoral condyle and lateral femoral condyle,medial tibia, lateral tibia and patella were measured respectively on T2 map imaging.The spatial variation in cartilage T2 value of femoral condyle was assessed. Statistical differences were analyzed. Results T2 value of diseased knees was significantly increased in all cartilage compartments compared with the controlled group(P<0.05). There was a significant difference in T2 value of non weight bearing site and weight bearing site of medial and lateral femoral condyle for the controlled group as well as the observed group(P<0.05). In the observed group, zonal variation was significant existed at the non weight bearing and weight bearing site(P<0.05). No significant differences were found between superficial and deep zone at the weight bearing site(P>0.05). Significant differences were found for the spatial variation in the controlled group (P<0.05). Paraphrase the T2 value of the corresponding T2 change state. Conclusion The clinical effect of MR T2-mapping imaging analysis diagnosis of knee OA is clear, and it can timely detect early OA articular cartilage changes, worthy of clinical popularization and application
【关键词】磁共振成像;膝关节;骨性关 节炎;T2值
【中图分类号】R684.3;R445.2
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.12.038
前言
膝关节是骨关节炎的好发部位,早期以疼痛和僵硬为主要表现, 发生于单侧或双侧交替,常在上下楼时出现症状[1]。中老年人为主要 患病对象,且女性的患病率稍高于男性。病情发展可导致关节软骨退 变甚至整个关节面的损伤,若不能早期诊断并治疗,可严重影响患者 的行动及生活质量[2]。影像学作为目前常用的疾病检查手段,可及时 准确地观察到关节软骨的异常改变,为临床确诊提供依据。为探究磁 共振T2-mapping成像定量早期诊断膝关节骨性关节炎的临床价值,选 取我院确诊并收治的200例膝关节早期OA患者及同期至我院体检的相同 人数的健康者作为研究对象,分别设为观察组和对照组,通过对比两 组人员的膝关节各部位软骨的T2值,分析其对于诊断早期OA的价值, 结果显示效果明确,具体如下。
中国CT和MRI杂志
第14卷, 第 12 期
2016年12月
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