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通过T1ρ磁共振成像映射检测年轻后交叉韧带损伤运动员的亚临床软骨退变。

Subclinical cartilage degeneration in young athletes with posterior cruciate ligament injuries detected with T1ρ magnetic resonance imaging mapping.

作者信息

Okazaki Ken, Takayama Yukihisa, Osaki Kanji, Matsuo Yoshio, Mizu-Uchi Hideki, Hamai Satoshi, Honda Hiroshi, Iwamoto Yukihide

机构信息

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-0054, Japan.

Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2015 Oct;23(10):3094-100. doi: 10.1007/s00167-014-3469-4. Epub 2014 Dec 7.

Abstract

PURPOSE

Prediction of the risk of osteoarthritis in asymptomatic active patients with an isolated injury of the posterior cruciate ligament (PCL) is difficult. T1ρ magnetic resonance imaging (MRI) enables the quantification of the proteoglycan content in the articular cartilage. The purpose of this study was to evaluate subclinical cartilage degeneration in asymptomatic young athletes with chronic PCL deficiency using T1ρ MRI.

METHODS

Six athletes with chronic PCL deficiency (median age 17, range 14-36 years) and six subjects without any history of knee injury (median age 31.5, range 24-33 years) were recruited. Regions of interest were placed on the articular cartilage of the tibia and the distal and posterior areas of the femoral condyle, and T1ρ values were calculated.

RESULTS

On stress radiographs, the mean side-to-side difference in posterior laxity was 9.8 mm. The T1ρ values at the posterior area of the lateral femoral condyle and the superficial layer of the distal area of the medial and lateral femoral condyle of the patients were significantly increased compared with those of the normal controls (p < 0.05). At the tibial plateau, the T1ρ values in both the medial and lateral compartments were significantly higher in patients compared with those in the normal controls (p < 0.05).

CONCLUSION

T1ρ MRI detected unexpected cartilage degeneration in the well-functioning PCL-deficient knees of young athletes. One should be alert to the possibility of subclinical cartilage degeneration even in asymptomatic patients who show no degenerative changes on plain radiographs or conventional MRI.

LEVEL OF EVIDENCE

IV.

摘要

目的

预测单纯后交叉韧带(PCL)损伤的无症状活跃患者发生骨关节炎的风险具有挑战性。T1ρ磁共振成像(MRI)能够定量关节软骨中的蛋白聚糖含量。本研究旨在使用T1ρ MRI评估慢性PCL缺乏的无症状年轻运动员的亚临床软骨退变情况。

方法

招募了6名慢性PCL缺乏的运动员(中位年龄17岁,范围14 - 36岁)和6名无膝关节损伤史的受试者(中位年龄31.5岁,范围24 - 33岁)。在胫骨和股骨髁远端及后部区域的关节软骨上设置感兴趣区,并计算T1ρ值。

结果

在应力X线片上,后方松弛度的平均左右差异为9.8 mm。与正常对照组相比,患者股骨外侧髁后部区域以及股骨内外侧髁远端表层的T1ρ值显著升高(p < 0.05)。在胫骨平台,患者内外侧间室的T1ρ值均显著高于正常对照组(p < 0.05)。

结论

T1ρ MRI检测到年轻运动员功能良好的PCL缺乏膝关节中存在意外的软骨退变。即使在X线平片或传统MRI上无退变改变的无症状患者中,也应警惕亚临床软骨退变的可能性。

证据级别

IV级。

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