Zbojniewicz Andrew M, Stringer Keith F, Laor Tal, Wall Eric J
1 Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229.
2 Department of Pathology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH.
AJR Am J Roentgenol. 2015 Jul;205(1):W114-23. doi: 10.2214/AJR.14.13579.
The objective of our study was to correlate specimens of juvenile osteochondritis dissecans (OCD) lesions of the knee to MRI examinations to elucidate the histopathologic basis of characteristic imaging features.
Five children (three boys and two girls; age range, 12-13 years old) who underwent transarticular biopsy of juvenile OCD lesions of the knee were retrospectively included in this study. Two radiologists reviewed the MRI examinations and a pathologist reviewed the histopathologic specimens and recorded characteristic features. Digital specimen photographs were calibrated to the size of the respective MR image with the use of a reference scale. Photographs were rendered semitransparent and over-laid onto the MR image with the location chosen on the basis of the site of the prior biopsy.
A total of seven biopsy specimens were included. On MRI, all lesions showed cystlike foci in the subchondral bone, bone marrow edema pattern on proton density-or T2-weighted images, and relatively thick unossified epiphyseal cartilage. In four patients, a laminar signal intensity pattern was seen, and two patients had multiple breaks in the subchondral bone plate. Fibrovascular tissue was found at histopathology in all patients. Cleft spaces near the cartilage-bone interface and were seen in all patients while chondrocyte cloning was present in most cases. Focal bone necrosis and inflammation were infrequent MRI findings. Precise correlation of the MRI appearance to the histopathologic overlays consistently was found.
A direct correlation exists between the histopathologic findings and the MRI features in patients with juvenile OCD. Additional studies are needed to correlate these MRI features with juvenile OCD healing success rates.
本研究的目的是将膝关节青少年剥脱性骨软骨炎（OCD）病变的标本与MRI检查相关联，以阐明特征性影像表现的组织病理学基础。
本研究回顾性纳入了5名接受膝关节青少年OCD病变经关节活检的儿童（3名男孩和2名女孩；年龄范围为12 - 13岁）。两名放射科医生对MRI检查进行了评估，一名病理科医生对组织病理学标本进行了评估并记录了特征性表现。使用参考标尺将数字标本照片校准为各自MR图像的大小。将照片处理为半透明，并根据先前活检部位选择的位置叠加到MR图像上。
共纳入7个活检标本。在MRI上，所有病变在软骨下骨均显示出囊肿样病灶，在质子密度或T2加权图像上表现为骨髓水肿模式，且骺软骨未骨化部分相对较厚。4例患者可见分层信号强度模式，2例患者软骨下骨板有多处断裂。所有患者在组织病理学检查中均发现了纤维血管组织。所有患者在软骨 - 骨界面附近均可见裂隙，大多数病例存在软骨细胞克隆。局灶性骨坏死和炎症在MRI上较少见。MRI表现与组织病理学叠加结果始终存在精确的相关性。
青少年OCD患者的组织病理学发现与MRI特征之间存在直接相关性。需要进一步的研究将这些MRI特征与青少年OCD的愈合成功率相关联。
