Ruiz Santiago Fernando, Pozuelo Calvo Rocío, Almansa López Julio, Guzmán Álvarez Luis, Castellano García María Del Mar
Department of Radiology, Traumatology Hospital, University Hospital Virgen de las Nieves, Granada, SPAIN.
Department of Rehabilitation and Physical therapy, Traumatology Hospital, University Hospital Virgen de las Nieves, Granada, SPAIN.
Eur J Radiol. 2014 Jun;83(6):984-988. doi: 10.1016/j.ejrad.2014.03.007. Epub 2014 Mar 24.
To study the correlation between the T2 relaxation times of the patellar cartilage and morphological MRI findings of chondromalacia.
This prospective study comprises 50 patients, 27 men and 23 women suffering of anterior knee pain (mean age: 29.7, SD 8.3 years; range: 16-45 years). MRI of 97 knees were performed in these patients at 1.5T magnet including sagittal T1, coronal intermediate, axial intermediate fat sat and T2 mapping. Chondromalacia was assessed using a modified version of Noyes classification. The relaxation time, T2, was studied segmenting the full thickness of the patellar cartilage in 12 areas: 4 proximal (external facet-proximal-lateral (EPL), external facet-proximal-central (EPC), internal facet-proximal-central (IPC), internal facet-proximal-medial (IPM), 4 in the middle section (external facet-middle-lateral (EML), external facet-middle-central (EMC), internal facet-middle-central (IMC), internal facet-middle-medial (IMM) and 4 distal (external facet-distal-lateral (EDL), external facet-distal-central (EDC), internal facet-distal-central (IDC), internal facet-distal-medial (IDM).
T2 values showed a significant increase in mild chondromalacia regarding normal cartilage in most of the cartilage areas (p<0.05), except in the internal distal facet (IDC and IDM), EPC, EDL, and IMM. Severe chondromalacia was characterized by a fall of T2 relaxation times with loss of statistical significant differences in comparison with normal cartilage, except in EMC and IMC, where similar values as mild chondromalacia were maintained (p<0.05).
Steepest increase in T2 values of patellar cartilage occurs in early stages of patellar cartilage degeneration. Progression of morphologic changes of chondromalacia to more severe degrees is associated to a new drop of T2 relaxation times approaching basal values in most of the areas of the patellar cartilage, except in the central area of the middle section, where T2 values remain increased.
研究髌软骨的T2弛豫时间与软骨软化症形态学MRI表现之间的相关性。
本前瞻性研究纳入了50例患者，其中27例男性和23例女性，均患有膝前疼痛（平均年龄：29.7岁，标准差8.3岁；范围：16 - 45岁）。这些患者在1.5T磁共振成像仪上对97个膝关节进行了检查，包括矢状面T1、冠状面中等权重、横断面中等权重脂肪抑制序列及T2成像。采用改良版的诺伊斯分类法评估软骨软化症。研究T2弛豫时间时，将髌软骨全层分为12个区域：4个近端区域（外侧小面近端外侧（EPL）、外侧小面近端中央（EPC）、内侧小面近端中央（IPC）、内侧小面近端内侧（IPM）），4个中间区域（外侧小面中间外侧（EML）、外侧小面中间中央（EMC）、内侧小面中间中央（IMC）、内侧小面中间内侧（IMM）），以及4个远端区域（外侧小面远端外侧（EDL）、外侧小面远端中央（EDC）、内侧小面远端中央（IDC）、内侧小面远端内侧（IDM））。
与正常软骨相比，在大多数软骨区域，轻度软骨软化症的T2值显著升高（p<0.05），但在内侧远端小面（IDC和IDM）、EPC、EDL和IMM区域除外。重度软骨软化症的特征是T2弛豫时间下降，与正常软骨相比失去统计学显著差异，但在EMC和IMC区域除外，这两个区域维持了与轻度软骨软化症相似的值（p<0.05）。
髌软骨T2值的最大增幅出现在髌软骨退变的早期阶段。软骨软化症形态学变化进展到更严重程度与T2弛豫时间在髌软骨大多数区域再次下降接近基础值相关，但中间部分的中央区域除外，该区域T2值仍升高。
