Huppertz Marc Sebastian, Schock Justus, Radke Karl Ludger, Abrar Daniel Benjamin, Post Manuel, Kuhl Christiane, Truhn Daniel, Nebelung Sven
Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany.
Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany.
Life (Basel). 2021 Mar 5;11(3):201. doi: 10.3390/life11030201.
Traumatic cartilage injuries predispose articulating joints to focal cartilage defects and, eventually, posttraumatic osteoarthritis. Current clinical-standard imaging modalities such as morphologic MRI fail to reliably detect cartilage trauma and to monitor associated posttraumatic degenerative changes with oftentimes severe prognostic implications. Quantitative MRI techniques such as T2 mapping are promising in detecting and monitoring such changes yet lack sufficient validation in controlled basic research contexts.
35 macroscopically intact cartilage samples obtained from total joint replacements were exposed to standardized injurious impaction with low (0.49 J, n = 14) or high (0.98 J, n = 14) energy levels and imaged before and immediately, 24 h, and 72 h after impaction by T2 mapping. Contrast, homogeneity, energy, and variance were quantified as features of texture on each T2 map. Unimpacted controls (n = 7) and histologic assessment served as reference.
As a function of impaction energy and time, absolute T2 values, contrast, and variance were significantly increased, while homogeneity and energy were significantly decreased.
T2 mapping and texture feature analysis are sensitive diagnostic means to detect and monitor traumatic impaction injuries of cartilage and associated posttraumatic degenerative changes and may be used to assess cartilage after trauma to identify "cartilage at risk".
创伤性软骨损伤使关节易于出现局灶性软骨缺损,并最终导致创伤后骨关节炎。当前的临床标准成像方式,如形态学磁共振成像(MRI),无法可靠地检测软骨损伤,也难以监测相关的创伤后退行性变化,而这些变化往往具有严重的预后意义。定量MRI技术,如T2映射,在检测和监测此类变化方面很有前景,但在受控的基础研究环境中缺乏充分验证。
从全关节置换术中获取35个宏观上完整的软骨样本,分别用低能量(0.49焦耳,n = 14)或高能量(0.98焦耳,n = 14)进行标准化损伤撞击,并在撞击前、撞击后即刻、24小时和72小时通过T2映射成像。将对比度、均匀性、能量和方差作为每个T2图上的纹理特征进行量化。未受撞击的对照样本(n = 7)和组织学评估作为参考。
作为撞击能量和时间的函数,绝对T2值、对比度和方差显著增加,而均匀性和能量显著降低。
T2映射和纹理特征分析是检测和监测软骨创伤性撞击损伤及相关创伤后退行性变化的敏感诊断手段,可用于评估创伤后的软骨,以识别“危险软骨”。