Hayes C W, Conway W F
Department of Radiology, Medical College of Virginia Hospitals, Richmond 23298-0615.
Radiographics. 1992 May;12(3):409-28. doi: 10.1148/radiographics.12.3.1609135.
Many diagnostic modalities may be used to evaluate articular cartilage. Plain radiography remains the preferred initial study for cartilage evaluation, although even specialized views such as weight-bearing, tunnel, and flexion lateral projections are insensitive in the detection of early cartilage loss. Compared with newer modalities, conventional arthrography has limited capacity for the assessment of cartilage. Computed tomography performed after intraarticular injection of contrast material (ie, CT arthrography) has improved accuracy but is essentially limited to the axial plane. Magnetic resonance (MR) imaging, with its superb soft-tissue contrast and multiplanar capabilities, has shown promise in depicting articular cartilage. Cartilage is best depicted when an "arthrogram effect" is present, achieved with T2-weighted spin-echo imaging, with some gradient-echo pulse sequences, and when intraarticular contrast material is used. If performed with such techniques, MR imaging is the method of choice for evaluating specific cartilage loss, osteochondritis dissecans, and other osteochondral abnormalities.
许多诊断方法可用于评估关节软骨。普通X线摄影仍是评估软骨的首选初始检查方法，尽管即使是负重、隧道位和屈曲侧位等特殊投照在早期软骨损伤的检测中也不敏感。与更新的方法相比，传统关节造影对软骨的评估能力有限。关节内注射造影剂后进行的计算机断层扫描（即CT关节造影）准确性有所提高，但基本上仅限于轴位平面。磁共振（MR）成像凭借其出色的软组织对比度和多平面成像能力，在显示关节软骨方面显示出前景。当存在“关节造影效应”时，软骨显示最佳，这可通过T2加权自旋回波成像、一些梯度回波脉冲序列以及使用关节内造影剂来实现。如果采用这些技术进行检查，MR成像是评估特定软骨损伤、剥脱性骨软骨炎和其他骨软骨异常的首选方法。
