Zilkens Christoph, Holstein Arne, Bittersohl Bernd, Jäger Marcus, Haamberg Tanja, Miese Falk, Kim Young-Jo, Mamisch Tallal C, Krauspe Rüdiger
Department of Orthopaedics, Heinrich-Heine University Medical School, Duesseldorf, Germany.
J Pediatr Orthop. 2010 Mar;30(2):147-53. doi: 10.1097/BPO.0b013e3181cf13e6.
Aim of this study was to assess the glycosaminoglycan content in hip joint cartilage in mature hips with a history of Legg-Calvé-Perthes (LCPD) disease using delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC).
Thirty one hips in 27 adults (mean age: 30.5+/-10.9 y) with LCPD in childhood were included. Mean follow-up after diagnosis was 24.5+/-11.4 years. Clinical symptoms and standard radiographic parameters were evaluated. dGEMRIC indices were calculated as T1(Gd) mean values in four coronal MRI slices medially, centrally, and laterally. For comparison, the morphologically normal appearing contra-lateral hips (21 hips) were assessed.
The following T1(Gd) values for the LCPD group were noted: medial (507+/-100 ms), central (543+/-104 ms), and lateral (553+/-105 ms). The total T1(Gd) mean value was 534+/-104 ms. The difference between LCPD and normal hips was statistically significant only for the medial compartment (P=0.018).
Hip joint cartilage after LCPD shows a significant glycosaminoglycan loss in the medial compartment while this decrease is less apparent centrally and laterally. dGEMRIC allows direct assessment of cartilage matrix biochemistry and may depict the complex damage pattern of hip joint cartilage after LCPD spatially and qualitatively better than other radiographic methods.
Prognostic study, Level II-1 (retrospective study).
本研究的目的是使用延迟钆增强磁共振软骨成像（dGEMRIC）评估有Legg-Calvé-Perthes（LCPD）病病史的成熟髋关节中关节软骨的糖胺聚糖含量。
纳入27名儿童期患有LCPD的成年人（平均年龄：30.5±10.9岁）的31个髋关节。诊断后的平均随访时间为24.5±11.4年。评估临床症状和标准影像学参数。dGEMRIC指数计算为四个冠状面MRI切片中外侧、中央和内侧的T1（Gd）平均值。为作比较，评估形态学上正常的对侧髋关节（21个髋关节）。
记录了LCPD组的以下T1（Gd）值：内侧（507±100毫秒）、中央（543±104毫秒）和外侧（553±105毫秒）。T1（Gd）总平均值为534±104毫秒。LCPD髋关节与正常髋关节之间的差异仅在内侧间室具有统计学意义（P = 0.018）。
LCPD后的髋关节软骨在内侧间室显示出明显的糖胺聚糖损失，而这种减少在中央和外侧不太明显。dGEMRIC可以直接评估软骨基质生物化学，并且在空间和质量上比其他影像学方法能更好地描绘LCPD后髋关节软骨的复杂损伤模式。
预后研究，II-1级（回顾性研究）。
