Holstein Arne, Zilkens Christoph, Bittersohl Bernd, Jäger Marcus, Haamberg Tanja, Mamisch Tallal C, Lanzman Rotem S, Kröpil Patric, Blondin Dirk, Krauspe Rüdiger, Antoch Gerald, Fürst Günther, Miese Falk
Department of Diagnostic and Interventional Radiology Department of Orthopaedics, University Hospital Düsseldorf, Medical Faculty, Düsseldorf, Germany Department of Orthopaedic Surgery, University Hospital Bern, Bern, Switzerland.
J Med Imaging Radiat Oncol. 2011 Jun;55(3):259-65. doi: 10.1111/j.1754-9485.2011.02262.x.
The purpose of the present study was to evaluate the feasibility of delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) in the detection of cartilage changes versus morphologic imaging in the long-term course of Legg-Calvé-Perthes disease (LCPD).
A total of 31 hips in 26 patients (mean age, 30.0years; range, 18-54years) who were diagnosed with LCPD in childhood were included. Twenty-one radiographically normal contralateral hips served as controls. dGEMRIC indices of femoral and acetabular cartilage in the weight-bearing zone. Cartilage morphology was classified on radial PD-weighted images according to the modified Outerbridge classification.
Mean dGEMRIC values of cartilage were significantly lower in hips after LCPD than in the radiographically normal contralateral hips (513±100 ms vs. 579±103 ms; P=0.026). In 24 out of 31 LCPD hips and in 4 out of 21 radiographically normal contralateral hips, morphological cartilage changes were noted. Analysis of variance analysis revealed a significant influence of Outerbridge grading on decreased T1-values (P=0.031).
Our results suggest that dGEMRIC at 1.5 T is suitable to assess cartilage quality changes in the long-term follow-up after LCPD. The evaluation of biochemical cartilage quality with dGEMRIC may provide additional information about early cartilage changes occurring without visible alterations of cartilage morphology.
本研究的目的是评估延迟钆增强磁共振成像（dGEMRIC）在检测Legg-Calvé-Perthes病（LCPD）长期病程中软骨变化与形态学成像方面的可行性。
纳入26例儿童期诊断为LCPD的患者共31个髋关节（平均年龄30.0岁；范围18 - 54岁）。21个对侧影像学正常的髋关节作为对照。测量负重区股骨和髋臼软骨的dGEMRIC指数。根据改良的Outerbridge分类在径向质子密度加权图像上对软骨形态进行分类。
LCPD后髋关节软骨的平均dGEMRIC值显著低于对侧影像学正常的髋关节（513±100毫秒对579±103毫秒；P = 0.026）。31个LCPD髋关节中有24个以及21个对侧影像学正常的髋关节中有4个出现了软骨形态学改变。方差分析显示Outerbridge分级对T1值降低有显著影响（P = 0.031）。
我们的结果表明，1.5T的dGEMRIC适用于评估LCPD长期随访中的软骨质量变化。用dGEMRIC评估软骨生化质量可能会提供有关在软骨形态无明显改变时发生的早期软骨变化的额外信息。
