School of Medicine, University of California, San Francisco, California, USA.
Arthroscopy. 2011 Jan;27(1):65-76. doi: 10.1016/j.arthro.2010.06.026. Epub 2010 Oct 29.
To quantitate bone marrow edema-like lesions (BMELs) and the radiologic properties of cartilage in knees with acute anterior cruciate ligament (ACL) injuries using T(1ρ) magnetic resonance imaging over a 1-year period.
Nine patients with ACL injuries were studied. Magnetic resonance imaging scans were acquired within 8 weeks of the injury, after which ACL reconstruction surgery was performed. Images were then acquired 0.5, 6, and 12 months after reconstructions. The volume and signal intensity of BMELs were quantified at baseline and follow-up examinations. T(1ρ) values were quantified in cartilage overlying the BMEL (OC) and compared with surrounding cartilage at all time points.
BMELs were most commonly found in the lateral tibia and lateral femoral condyle. Nearly 50% of BMELs resolved over a 1-year period. The T(1ρ) values of the OC in the lateral tibia, medial tibia, and medial femoral condyle were elevated compared with respective regions in surrounding cartilage at all time points; the difference was significant only in the lateral tibia (P < .05). The opposite results were found in the lateral femoral condyle. For the medial tibia and medial femoral condyle, none of the time periods was significantly different. The percent increase in T(1ρ) values of OC in the lateral tibia was significantly correlated with BMEL volume (r = 0.74, P < .05). At 1 year, the OC in the lateral tibia, medial tibia, and medial femoral condyle showed increased T(1ρ) values despite improvement of BMEL.
In patients after ACL tear and reconstruction, (1) the cartilage overlying BMEL in the lateral tibia experiences persistent T(1ρ) signal changes immediately after acute injuries and at 1-year follow-up despite BMEL improvement, (2) the superficial layers of the overlying cartilage show greater matrix damage than the deep layers, and (3) the volume of the BMEL may predict the severity of the overlying matrix's damage in the lateral tibia. T(1ρ) is capable of quantitatively and noninvasively monitoring this damage and detecting early cartilage changes in the lateral tibia over time.
Level IV, therapeutic case series.
使用 T(1ρ)磁共振成像在 ACL 损伤后 1 年内定量测量骨髓水肿样病变（BMEL）和软骨的放射学特征。
研究了 9 例 ACL 损伤患者。损伤后 8 周内进行磁共振成像扫描，然后进行 ACL 重建手术。然后在重建后 0.5、6 和 12 个月进行图像采集。在基线和随访检查时定量测量 BMEL 的体积和信号强度。在所有时间点定量测量 BMEL 上方软骨（OC）的 T(1ρ)值，并与周围软骨进行比较。
BMEL 最常见于外侧胫骨和外侧股骨髁。近 50%的 BMEL 在 1 年内消退。外侧胫骨、内侧胫骨和内侧股骨髁 OC 的 T(1ρ)值在所有时间点均高于周围软骨相应区域；仅在外侧胫骨时差异具有统计学意义（P <.05）。在外侧股骨髁中则得到了相反的结果。对于内侧胫骨和内侧股骨髁，没有一个时间段具有显著差异。外侧胫骨 OC 的 T(1ρ)值增加百分比与 BMEL 体积显著相关（r = 0.74，P <.05）。在 1 年时，尽管 BMEL 改善，但外侧胫骨、内侧胫骨和内侧股骨髁的 OC 仍显示 T(1ρ)值增加。
在 ACL 撕裂和重建后患者中，（1）在急性损伤后和 1 年随访时，外侧胫骨 BMEL 上方的软骨持续出现 T(1ρ)信号变化，尽管 BMEL 有所改善，（2）覆盖软骨的浅层显示出比深层更大的基质损伤，（3）BMEL 的体积可能预测外侧胫骨覆盖基质损伤的严重程度。T(1ρ)能够定量、非侵入性地监测这种损伤，并随着时间的推移检测外侧胫骨软骨的早期变化。
IV 级，治疗性病例系列。
