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一项使用 3D T1ρ 映射的初步研究,用于定量评估开放式楔形胫骨高位截骨术后软骨的变化。

A pilot study with 3D T1ρ-mapping for quantitative evaluation of cartilage after open-wedge high tibial osteotomy.

机构信息

Department of Orthopaedic Surgery, Nara Seiwa Medical Center, Sango town, Ikoma-gun, Japan.

Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan.

出版信息

Eur J Radiol. 2022 Jun;151:110308. doi: 10.1016/j.ejrad.2022.110308. Epub 2022 Apr 9.

Abstract

PURPOSE

To evaluate the recently developed three-dimensional (3D) T1ρ-mapping technique for the quantitative evaluation of cartilage changes after open-wedge high tibial osteotomy (OWHTO).

METHOD

Eleven patients with medial knee osteoarthritis and spontaneous osteonecrosis of the medial femoral condyle underwent T1ρ magnetic resonance imaging. The full-thickness cartilage of the medial femoral condyle (MFC), lateral femoral condyle, medial tibial condyle, and lateral tibial condyle, and the trochlea and patella were set as regions of interest; mean T1ρ values were calculated using two-dimensional (2D) and 3D analyses. The state of cartilage injury was evaluated using the International Cartilage Repair Society grading system (ICRS grade). T1ρ values before OWHTO and after hardware removal were compared using the Wilcoxon signed-rank test. The correlation between T1ρ values and the ICRS grade was explored using the Spearman rank correlation coefficient.

RESULTS

Cartilage repair at the MFC was observed in a high proportion of patients (82%), but 2D analysis did not reveal a significant difference after surgery at any site. In contrast, 3D analysis revealed a significant decrease in T1ρ values after surgery at the MFC (before surgery: 44.1 ms; after surgery: 38.9 ms; p = 0.016), but no significant difference at any other site. In the MFC, there was a positive correlation between 3D T1ρ values and arthroscopic findings before and after surgery (rs = 0.62, p < 0.01), which was absent from the 2D T1ρ values.

CONCLUSIONS

3D T1ρ-mapping may be an effective tool for detecting changes in cartilage quality after OWHTO.

摘要

目的

评估最近开发的三维(3D)T1ρ 映射技术在开放式楔形胫骨高位截骨术(OWHTO)后软骨变化的定量评估中的应用。

方法

11 例内侧膝关节骨关节炎和自发性内侧股骨髁骨坏死患者接受了 T1ρ 磁共振成像检查。内侧股骨髁(MFC)、外侧股骨髁、内侧胫骨髁和外侧胫骨髁的全层软骨以及滑车和髌骨被设定为感兴趣区;使用二维(2D)和 3D 分析计算平均 T1ρ 值。使用国际软骨修复学会(ICRS)分级系统评估软骨损伤状态。使用 Wilcoxon 符号秩检验比较 OWHTO 前和去除内固定物后的 T1ρ 值。使用 Spearman 秩相关系数探索 T1ρ 值与 ICRS 分级之间的相关性。

结果

在大多数患者(82%)中观察到 MFC 处的软骨修复,但在任何部位手术后 2D 分析均未显示出显著差异。相比之下,3D 分析显示 MFC 手术后 T1ρ 值显著降低(术前:44.1ms;术后:38.9ms;p=0.016),但在其他任何部位均无显著差异。在 MFC 中,3D T1ρ 值与术前和术后关节镜检查结果之间存在正相关(rs=0.62,p<0.01),而 2D T1ρ 值则不存在这种相关性。

结论

3D T1ρ 映射可能是检测 OWHTO 后软骨质量变化的有效工具。

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