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ACL 重建膝关节的软骨形态学及 T1ρ 和 T2 值定量:2 年随访。

Cartilage morphology and T1ρ and T2 quantification in ACL-reconstructed knees: a 2-year follow-up.

机构信息

Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California-San Francisco, CA 94107, USA.

出版信息

Osteoarthritis Cartilage. 2013 Aug;21(8):1058-67. doi: 10.1016/j.joca.2013.05.010. Epub 2013 May 22.

Abstract

OBJECTIVE

To describe cartilage matrix and morphology changes, assessed using quantitative magnetic resonance imaging (MRI), after acute anterior cruciate ligament (ACL) injury relative to controls and longitudinally during 2 years following reconstruction.

METHOD

Fifteen patients with acute ACL injuries and 16 healthy volunteers with a similar demographic profile but no history of osteoarthritis or knee injury were studied. The injured knee of each participant was imaged with a 3.0 T MR scanner at baseline (prior to ACL reconstruction); patients' knees were re-imaged 1 and 2 years after ACL reconstruction. Cartilage T1ρ and T2 values in full thickness, superficial layers, and deep layers, and cartilage thickness of the full layer were quantified within subcompartments of the knee joint.

RESULTS

In the posterolateral tibial cartilage, T1ρ values were significantly higher in ACL-injured knees than control knees at baseline and were not fully recovered 2 after ACL reconstruction. T1ρ values of medial tibiofemoral cartilage in ACL-injured knees increased over the 2-year study and were significantly elevated compared to that of the control knees. T2 values in cartilage of the central aspect of the medial femoral condyle at the 2-year follow-up were significantly elevated compared with control knees. Cartilage in the posterior regions of the lateral tibia was significantly thinner, while cartilage in the central aspect of the medial femur was significantly thicker than that of controls. Patients with lesions in the posterior horn of the medial meniscus exhibited significantly higher T1ρ values in weight-bearing regions of the tibiofemoral cartilage than that of control subjects over the 2-year period, whereas patients without medial meniscal tears did not.

CONCLUSION

Quantitative MRI provides powerful in vivo tools to quantitatively evaluate early changes of cartilage matrix and morphology after acute ACL injury and reconstruction, which may possibly relate to the development of post-traumatic osteoarthritis in such joints.

摘要

目的

描述急性前交叉韧带(ACL)损伤后相对于对照者和重建后 2 年内的纵向变化,使用定量磁共振成像(MRI)评估软骨基质和形态变化。

方法

研究了 15 例急性 ACL 损伤患者和 16 例具有相似人口统计学特征但无骨关节炎或膝关节损伤史的健康志愿者。每位参与者的受伤膝关节均在基线(ACL 重建前)使用 3.0 T MR 扫描仪进行成像;患者的膝关节在 ACL 重建后 1 年和 2 年时再次进行成像。在膝关节亚区定量测量全层、浅层和深层的软骨 T1ρ 和 T2 值以及全层软骨厚度。

结果

在外侧胫骨软骨的后外侧,ACL 损伤膝关节的 T1ρ 值在基线时明显高于对照膝关节,并且在 ACL 重建后 2 年时并未完全恢复。ACL 损伤膝关节的内侧胫股软骨的 T1ρ 值在 2 年研究期间增加,并明显高于对照膝关节。内侧股骨髁中央软骨的 T2 值在 2 年随访时明显高于对照膝关节。外侧胫骨后区的软骨明显变薄,而内侧股骨中央区的软骨明显比对照者厚。内侧半月板后角损伤的患者在 2 年内,负重区的胫骨股骨软骨 T1ρ 值明显高于对照者,而无内侧半月板撕裂的患者则没有。

结论

定量 MRI 提供了强大的体内工具,可定量评估急性 ACL 损伤和重建后软骨基质和形态的早期变化,这可能与这些关节创伤后骨关节炎的发展有关。

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