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[软骨成像]

[Imaging of cartilage].

作者信息

Glaser C

机构信息

Institut für Klinische Radiologie, Klinikum Grosshadern der Ludwig-Maximilians-Universität München.

出版信息

Radiologe. 2006 Jan;46(1):16-25. doi: 10.1007/s00117-005-1287-x.

Abstract

The motivation for cartilage repair is the preservation of adequate joint motion. Repairing joint surface congruity and providing balanced load bearing are crucial for this. MRI can contribute to this goal by describing number, depth, size, and distribution of cartilage lesions throughout the different joint compartments. Essential to such a contribution are adequate spatial resolution at a reasonable SNR together with good contrast between both cartilage and the subchondral bone as well as the joint space. For TSE sequences, this is achieved using TEs between 30 and 50 ms. Diagnostic accuracy is optimal when a lesion is depicted in more than one plane. Short TE, high bandwidth, and the appropriate orientation of the frequency encoding direction contribute to minimizing metal artifacts. Besides internal alterations of the cartilage's matrix, moderately T2-weighted TSE sequences sensitively depict bone marrow edema such as signal alterations and joint effusion, both contributing to highlight even subtle cartilage lesions. T1-weighted FS/WE 3D GE sequences profit from their high spatial resolution to appreciate gradual erosion of the cartilage. In OD the interface to the surrounding bone, the integrity of the overlying cartilage, and associated cysts are used to determine stability. The presence of two or more findings increases diagnostic accuracy. Prognosis is associated with the size of the affected area.

摘要

软骨修复的目的是保持关节的充分活动。修复关节表面的一致性并提供平衡的负重对此至关重要。MRI可以通过描述不同关节腔中软骨损伤的数量、深度、大小和分布来助力实现这一目标。要实现这种助力,在合理的信噪比下要有足够的空间分辨率,同时软骨与软骨下骨以及关节间隙之间要有良好的对比度。对于TSE序列,使用30至50毫秒之间的回波时间(TE)可实现这一点。当在多个平面上显示病变时,诊断准确性最佳。短TE、高带宽以及频率编码方向的适当取向有助于将金属伪影降至最低。除了软骨基质的内部改变外,中等T2加权的TSE序列能敏感地显示骨髓水肿,如信号改变和关节积液,这两者都有助于凸显即使是细微的软骨损伤。T1加权脂肪抑制/水激发3D梯度回波序列因其高空间分辨率而有助于观察软骨的逐渐侵蚀。在骨关节炎(OA)中,与周围骨的界面、上层软骨的完整性以及相关囊肿被用于确定稳定性。存在两个或更多发现可提高诊断准确性。预后与受影响区域的大小有关。

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