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人体软骨的定量磁共振成像:与关节镜下压痕硬度及缺损严重程度的关系

Quantitative MRI of Human Cartilage In Vivo: Relationships with Arthroscopic Indentation Stiffness and Defect Severity.

作者信息

Svärd Tuomas, Lakovaara Martti, Pakarinen Harri, Haapea Marianne, Kiviranta Ilkka, Lammentausta Eveliina, Jurvelin Jukka, Tervonen Osmo, Ojala Risto, Nieminen Miika

机构信息

1 Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Oulun lääni, Finland.

2 Terveystalo Ltd, Oulu, Oulun lääni, Finland.

出版信息

Cartilage. 2018 Jan;9(1):46-54. doi: 10.1177/1947603516684592. Epub 2016 Dec 28.

Abstract

Objective To investigate the association of cartilage defect severity, as determined by the International Cartilage Repair Society (ICRS) grading with indentation stiffness and T2 relaxation time of magnetic resonance imaging (MRI), a biomarker for the integrity of articular cartilage. Design Twenty-one patients scheduled for arthroscopic were included in the study. Prior to arthroscopy, subjects underwent quantitative MRI of articular cartilage, namely T2 relaxation time mapping at 1.5 T. Within 2 months, subjects underwent arthroscopy, which also included ICRS grading and measurement of arthroscopic indentation stiffness. Arthroscopic evaluations and T2 mapping at anterior, central, and posterior medial and lateral femoral condyles were correlated using a colocalization scheme. Differences in Young's modulus, as derived by indentation tests, and T2 times between ICRS grades were analyzed using Mann-Whitney's U or Kruskal-Wallis H tests. The correlation between modulus and T2 times was analyzed using Spearman's rank correlation coefficients. Results Modulus and T2 showed significant topographical variation. In the anterior region of interest (ROI) on the medial condyle the modulus showed a negative association with ICRS grade ( P = 0.040) and the T2 times were longer in ICRS grade 2 compared with grades 0 and 1 ( P = 0.047). Similar, but nonsignificant associations were found in the central ROI on the medial condyle. No significant correlations were observed between the indentation modulus and T2 times. Conclusions Cartilage degeneration is identified both with mechanical indentation and T2 mapping in MRI. However, in this study, indentation stiffness and T2 relaxation time in vivo, were not associated.

摘要

目的 采用磁共振成像(MRI)的压痕硬度及T2弛豫时间(一种用于评估关节软骨完整性的生物标志物),研究由国际软骨修复协会(ICRS)分级确定的软骨缺损严重程度之间的关联。设计 本研究纳入了21例计划接受关节镜检查的患者。在关节镜检查前,受试者接受了关节软骨的定量MRI检查,即在1.5T下进行T2弛豫时间成像。在2个月内,受试者接受了关节镜检查,其中包括ICRS分级及关节镜下压痕硬度测量。采用共定位方案对股骨内侧髁前、中、后内侧及外侧的关节镜评估与T2成像进行相关性分析。使用Mann-Whitney U检验或Kruskal-Wallis H检验分析ICRS分级之间的压痕试验得出的杨氏模量及T2时间差异。使用Spearman等级相关系数分析模量与T2时间之间的相关性。结果 模量和T2显示出显著的局部变化。在内侧髁的前部感兴趣区域(ROI),模量与ICRS分级呈负相关(P = 0.040),与0级和1级相比,ICRS 2级的T2时间更长(P = 0.047)。在内侧髁的中央ROI发现了类似但不显著的关联。压痕模量与T2时间之间未观察到显著相关性。结论 在MRI中,通过机械压痕和T2成像均可识别软骨退变。然而,在本研究中,体内压痕硬度与T2弛豫时间并无关联。

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