Murakami Koji, Arai Yuji, Ikoma Kazuya, Kato Kammei, Inoue Hiroaki, Nakagawa Shuji, Fujii Yuta, Ueshima Keiichiro, Fujiwara Hiroyoshi, Kubo Toshikazu
Department of Orthopaedics Department of Sports and Para-Sports Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Medicine (Baltimore). 2018 Jun;97(23):e11011. doi: 10.1097/MD.0000000000011011.
The aim of this study was to perform quantitative evaluation of degeneration of joint cartilage using T2 mapping in magnetic resonance imaging (MRI) after arthroscopic partial resection of the lateral meniscus.The subjects were 21 patients (23 knees) treated with arthroscopic partial resection of the lateral meniscus. MRI was performed for all knees before surgery and 6 months after surgery to evaluate the center of the lateral condyle of the femur in sagittal images for T2 mapping. Ten regions of interest (ROIs) on the articular cartilage were established at 10-degree intervals, from the point at which the femur shaft crossed the lateral femoral condyle joint to the articular cartilage 90° relative to the femur shaft. Preoperative and postoperative T2 values were evaluated at each ROI. Age, sex, body mass index, femorotibial angle, Tegner score, and amount of meniscal resection were evaluated when the T2 value increased more than 6% at 30°.T2 values at approximately 10 °, 20 °, 30 °, 40 °, 50 °, and 60 ° degrees relative to the anatomical axis of the femur were significantly greater postoperatively (3.1, 3.6, 5.5, 4.4, 5.0, 6.4%, respectively) than preoperatively. A >6% increase at 30° was associated with total resection of any segment of the meniscus.Degeneration of the articular cartilage, as shown by the disorganization of collagen arrays at positions approximately 10 °, 20 °, 30 °, 40 °, 50 °, and 60 ° relative to the anatomical axis of the femur, may start soon after arthroscopic lateral meniscectomy. Total resection of any segment of the lateral meniscus may cause T2 elevation of articular cartilage of lateral femoral condyle.
本研究的目的是在关节镜下外侧半月板部分切除术后，利用磁共振成像（MRI）中的T2 mapping对关节软骨退变进行定量评估。研究对象为21例接受关节镜下外侧半月板部分切除术的患者（23个膝关节）。所有膝关节在术前及术后6个月均进行MRI检查，以在矢状位图像上评估股骨外侧髁中心进行T2 mapping。在股骨骨干与股骨外侧髁关节相交点至相对于股骨干90°的关节软骨处，以10度间隔在关节软骨上建立10个感兴趣区域（ROI）。在每个ROI处评估术前和术后的T2值。当30°处T2值升高超过6%时，评估年龄、性别、体重指数、股胫角、Tegner评分和半月板切除量。相对于股骨干解剖轴约10°、20°、30°、40°、50°和60°处的T2值术后显著高于术前（分别为3.1%、3.6%、5.5%、4.4%、5.0%、6.4%）。30°处升高>6%与半月板任何节段的全切除有关。相对于股骨干解剖轴约10°、20°、30°、40°、50°和60°位置处的胶原纤维排列紊乱所显示的关节软骨退变，可能在关节镜下外侧半月板切除术后不久就开始。外侧半月板任何节段的全切除可能导致股骨外侧髁关节软骨的T2值升高。
