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膝关节骨关节炎中关节软骨的定量磁共振成像

Quantitative magnetic resonance imaging of articular cartilage in knee osteoarthritis.

作者信息

Raynauld Jean-Pierre

机构信息

Osteoarthritis Clinical Research Program, Montreal Rheumatology Institute, Quebec, Canada.

出版信息

Curr Opin Rheumatol. 2003 Sep;15(5):647-50. doi: 10.1097/00002281-200309000-00021.

Abstract

PURPOSE OF REVIEW

Attempts to evaluate knee cartilage damage and progression seem logical in osteoarthritis research. Magnetic resonance imaging allows for precise visualization of joint structures such as cartilage, bone, synovial tissues, ligaments and menisci, and their pathologic changes.

RECENT FINDINGS

Recent advances in magnetic resonance technology have enabled researchers to evaluate cartilage damage and progression over the cross-sectional and longitudinal planes. Although anatomic changes can be seen, for many years the quantification of the cartilage changes has been the real challenge. Quantitative assessment of cartilage morphology using magnetic resonance imaging with fat-suppressed gradient echo sequences and digital postprocessing techniques provides high accuracy and adequate precision for cross-sectional and longitudinal studies in osteoarthritis patients. Recent data on precision, reliability, and sensitivity to change of quantitative parameters of cartilage morphology in osteoarthritis are presented in this review. Longitudinal studies currently available suggest that changes of cartilage volume, potentially as much as 5% per year, occur in osteoarthritis in most knee compartments, exceeding the variability of these measurements.

SUMMARY

Magnetic resonance imaging provides reliable and quantitative data on cartilage status throughout all compartments of the knee, and robust acquisition protocols for multicenter trials are now available. Magnetic resonance imaging technology should hopefully reduce the number of patients needed in clinical trials, improve retention of these patients, and reduce the overall costs and the length of clinical trials of treatment response to disease-modifying osteoarthritis drugs.

摘要

综述目的

在骨关节炎研究中,尝试评估膝关节软骨损伤及其进展似乎是合乎逻辑的。磁共振成像能够精确显示关节结构,如软骨、骨骼、滑膜组织、韧带和半月板及其病理变化。

最新发现

磁共振技术的最新进展使研究人员能够在横断面和纵向上评估软骨损伤及其进展。虽然解剖学变化可以观察到,但多年来软骨变化的量化一直是真正的挑战。使用脂肪抑制梯度回波序列磁共振成像和数字后处理技术对软骨形态进行定量评估,为骨关节炎患者的横断面和纵向研究提供了高准确性和足够的精度。本综述介绍了骨关节炎中软骨形态定量参数的精度、可靠性和对变化的敏感性的最新数据。目前可用的纵向研究表明,在大多数膝关节腔中,骨关节炎患者的软骨体积每年可能会有高达5%的变化,超过了这些测量的变异性。

总结

磁共振成像为膝关节所有腔室的软骨状态提供了可靠的定量数据,现在已有适用于多中心试验的强大采集方案。磁共振成像技术有望减少临床试验所需的患者数量,提高这些患者的留存率,并降低总体成本以及疾病修饰性骨关节炎药物治疗反应临床试验的时长。

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