Trattnig S, Mlynárik V, Jung B, Bader T, Sulzbacher I, Herneth A, Gaisch R, Puig S
Department of Radiology, University of Vienna, AKH-Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Magn Reson Imaging. 2001 Feb;19(2):187-92. doi: 10.1016/s0730-725x(01)00228-4.
The purpose of this study was to examine if an unusual bilaminar pattern of lateral tibial condyle cartilage layer on the fat-suppressed three-dimensional (3D) spoiled gradient echo sequence is artifactual or correlates with structural and/or biochemical composition of cartilage. The laminar appearance of the lateral tibial condyle cartilage layer was studied on fat-suppressed 3D spoiled gradient echo MR images of the knee joint in 67 patients (mean age: 28y) performed at 1.0 Tesla. After i.v. administration of gadopentetate dimeglumine, diffusion of the contrast media into cartilage layer was qualitatively analysed over time on inversion recovery spin echo images of knee joints of five asymptomatic volunteers (mean age: 25y). In a patient with osteosarcoma and total knee replacement, MR examination of cartilage layer of lateral tibial plateau was compared with histologic specimens stained with Safranin-O, demonstrating proteoglycan distribution in cartilage. The retrospective analysis of 67 knee joints revealed a bilaminar appearance of lateral tibial condyle cartilage layer in the gradient echo images in the majority of cases (81%) with a statistically significant tendency to a trilaminar pattern in patients older than 20 years. With i.v. contrast administration, the contrast enhancement was only observed in the superficial zone of tibial cartilage layer. Histologic specimens in one patient demonstrated a good correlation between thickness of proteoglycan-free and proteoglycan-rich laminae of lateral tibial condyle on Safranin-O staining with hyperintense and hypointense zones, respectively, on corresponding fat-suppressed 3D spoiled gradient echo images (correlation coefficient of 0.87). Bilaminar pattern of tibial condyle cartilage layer on fat-suppressed 3D spoiled gradient echo images in younger subjects is not an artifact or an intrachondral lesion, but it may represent a regional difference in composition of extracellular cartilage matrix possibly produced by a highly-oriented collagen fiber structure associated with a high concentration of proteoglycans in the middle and deep portion of the cartilage layer.
本研究的目的是检验在脂肪抑制三维（3D）扰相梯度回波序列上，胫骨外侧髁软骨层呈现的异常双分层模式是伪影，还是与软骨的结构和/或生化组成相关。在1.0特斯拉下，对67例患者（平均年龄：28岁）膝关节的脂肪抑制3D扰相梯度回波磁共振成像（MR图像）上胫骨外侧髁软骨层的分层表现进行了研究。静脉注射钆喷酸葡胺后，在5名无症状志愿者（平均年龄：25岁）膝关节的反转恢复自旋回波图像上，对造影剂向软骨层的扩散随时间进行了定性分析。在1例骨肉瘤并行全膝关节置换的患者中，将胫骨外侧平台软骨层的MR检查结果与用番红O染色的组织学标本进行比较，以显示软骨中蛋白聚糖的分布情况。对67个膝关节的回顾性分析显示，在大多数病例（81%）中，梯度回波图像上胫骨外侧髁软骨层呈现双分层表现，20岁以上患者呈现三层模式的趋势具有统计学意义。静脉注射造影剂后，仅在胫骨软骨层的表层观察到对比增强。1例患者的组织学标本显示，在相应的脂肪抑制3D扰相梯度回波图像上，胫骨外侧髁无蛋白聚糖层和富含蛋白聚糖层的厚度与番红O染色上的高信号区和低信号区分别具有良好的相关性（相关系数为0.87）。在年轻受试者脂肪抑制3D扰相梯度回波图像上，胫骨髁软骨层的双分层模式不是伪影或软骨内病变，但它可能代表细胞外软骨基质组成的区域差异，这可能是由软骨层中部和深部与高浓度蛋白聚糖相关的高度定向胶原纤维结构产生的。
