基于磁共振多模态影像监测关节软骨变化的定性及定量研究

发布时间：2018-06-13 00:29

本文选题：磁共振 + 双翻转角　；参考：《南京医科大学》2017年博士论文

【摘要】：第一部分基于双翻转角的3D T1 mapping技术在膝关节软骨磁共振成像(dGEMRIC)的可行性:病理及生化对照研究目的:通过对猪膝关节软骨模型病理及生化对照研究,探讨基于双翻转角的3D T1 mapping延迟增强磁共振成像技术检查关节软骨退变可行性。方法:本实验采用15只健康成年明尼苏达荷曼系小型猪,随机将其分为3组,每组5只。每只小型猪的左侧膝关节的前交叉韧带切除进行骨性关节炎造模。分别在造模型后0周,3周,6周对其中一组小型猪使用基于双翻转角的3D T1 mapping技术进行延迟钆增强磁共振软骨成像(dGEMRIC),磁共振扫描结束后将小型猪处死,取出左侧膝关节进行组织化学染色及生化成分分析。对磁共振数据及生化成分数据进行相关性分析。结果:相关性分析发现实验组的磁共振dGEMRIC T1值与关节软骨中糖胺多糖(GAG)含量呈正相关性(1=0.85,p0.05)。dGEMRICT1值与胶原蛋白含量没有明显相关性。dGEMRIC T1值显示前交叉韧带切除术后股骨内侧髁关节软骨T1值随着时间逐渐下降(p0.05)。病理切片显示软骨损伤程度与MRI数据一致。结论:使用双翻转角3D T1 mapping获取延迟增强软骨T1值评估早期软骨退变是可行的。这项技术在合理时间内能够获取足够的分辨率对于研究者和临床医生来说非常重要。第二部分磁共振成像定量分析对软骨退变的诊断:动物实验研究目的:对小型猪膝关节前交叉韧带切断制作骨性关节炎模型,利用延迟钆增强磁共振软骨成像(dGEMRIC)以及T2弛豫时间成像(T2 mapping)分析骨关节炎软骨组织退化过程。方法:12只小型猪左膝前交叉韧带切除术后,利用延迟钆增强磁共振软骨成像(dGEMRIC),和T2弛豫时间成像观察2周,4周,6周后软骨组织退化情况(n=4).同时,对未患有骨关节炎的4只小型猪膝关节作为对照组,进行相同的观察实验。提取的左股骨内侧髁承重区软骨样本,进行大体观察,组织学分析,免疫组织学分析,以及生化分析。使用皮尔森相关分析法,分析软骨生化组织成分与磁共振软骨成像定量数据(T1Gd和T2值)之间的相关性。结果:T1Gd值逐渐降低,T2值逐渐升高。4周后软骨组织表面呈现凹凸状。6周后出现局部软骨缺损,糖胺聚糖(GAG)分布及含量随时间逐渐减少(P0.05),胶原分布以及其各向异性变化显著。然而,胶原蛋白含量在术后个时间点没有发生重要改变。糖胺聚糖含量与T1Gd之呈正相关(r=0.888;P0.001),与T2值呈负相关(r=0.865;P0.001).胶原含量则与dGEMRIC T1Gd及T2值没有明显关系。结论:通过延迟钆增强磁共振软骨成像(dGEMRIC)以及T2弛豫时间成像(T2 mapping)观察小猪膝关节前交叉韧带切除术后软骨组织退化过程的分析,表明骨性关节炎早期诊断是可行的。第三部分基于双翻转角3DT1mapping获取dGEMRIC测量猪动物模型膝关节软骨的可重复性研究目的:评估3.0 T三维膝关节软骨延迟钆增强MR成像(dGEMRIC)在正常猪动物模型定量分析中的可重复性。材料与方法:20只健康成年明尼苏达荷曼系小型猪在7 d内行两次3.0 T三维T1 mapping膝关节dGEMRIC。为校正在采集过程中运动伪影,所有影像都严格进行三维校准。在每只猪膝关节的两种影像上对8个关节软骨解剖学上的感兴趣区进行分析。基于T 1影像的dGEMRIC的可重复性检测在每只猪膝关节每一层面的2个感兴趣区之间分别进行评估,T1影像可在空间上分辨关节软骨的质量。使用同类相关系数(ICC)和Bland-Altman图法对可重复性进行评估。结果:ICC的范围为0.86～0.95,表明软骨dGEMRIC扫描具有较好的可重复性。使用Bland-Altman图分析,可确定在纵向研究中使用dGEMRIC判断结果的变化,可以将95 ms作为具有差异的阈值。结论:膝关节软骨三维延迟钆增强3.0TMR成像与三维图像校准,在早期的膝关节炎诊断中显示软骨的质量具有较高的可重复性。在动物模型的纵向研究中,基于两个翻转角的3D T1 mapping序列采集软骨dGEMRIC T1值可以作为一种对评价关节软骨有价值的无创性检查技术。主要结论:①膝关节软骨延迟钆增强MR成像(dGEMRIC)可以评估关节软骨。②对动物模型膝关节软骨评估中,dGEMRIC可产生具有较高可重复性的T 1值。③建立的阈值可以确定dGEMRIC结果的显著性改变。④在纵向研究中,dGEMRIC可以用来评估软骨质量。
[Abstract]:The first part is based on the feasibility of 3D T1 mapping technique in knee joint cartilage magnetic resonance imaging (dGEMRIC) based on double turning angle: pathological and biochemical comparison study. Through the pathological and biochemical study of the cartilage model of the pig's knee joint, the 3D T1 mapping magnetic resonance imaging (3D) magnetic resonance imaging (3D) based on the double turn angle of the articular cartilage is used to examine the degeneration of articular cartilage Methods: 15 healthy adult Minnesota hogs were randomly divided into 3 groups, each group was divided into 3 groups, 5 in each group. The anterior cruciate ligament of the left knee joint of each small pig was excised for osteoarthritis model. The 3D T1 mapping based on double turn angle was used for a group of small pigs at 0 weeks, 3 weeks and 6 weeks after the model. The technique was delayed by gadolinium enhanced magnetic resonance cartilage imaging (dGEMRIC). After the MRI scan, the miniature pig was executed, the left knee joint was taken out for histochemical staining and biochemical analysis. The correlation analysis of magnetic resonance data and biochemical composition data was carried out. Results: the correlation analysis found the dGEMRIC T1 value of the experimental group and the correlation of the test group. There was a positive correlation between the content of glycosaminoglycan (GAG) in the articular cartilage (1=0.85, P0.05) and there was no significant correlation between the.DGEMRICT1 value and the collagen content..dGEMRIC T1 values showed that the femoral medial condyle cartilage T1 value decreased gradually after the anterior cruciate ligament resection (P0.05). The pathological slice showed that the degree of cartilage injury was in accordance with the MRI data. Conclusion: the use of the cartilage was consistent with the MRI data. Double turn angle 3D T1 mapping to obtain delayed enhanced cartilage T1 value evaluation of early cartilage degeneration is feasible. This technique can obtain sufficient resolution within a reasonable time for researchers and clinicians. Second parts of magnetic resonance imaging quantitative analysis of cartilage degeneration: animal experimental research purposes: to small size A model of osteoarthritis with the anterior cruciate ligament of the knee joint was made. The delayed gadolinium enhanced magnetic resonance imaging (dGEMRIC) and T2 relaxation time imaging (T2 mapping) were used to analyze the degeneration of cartilage tissue in osteoarthritis. Methods: after the resection of the anterior cruciate ligament of left knee in 12 small pigs, delayed gadolinium enhanced MRI (dGEMRIC) was used. T2 relaxation time imaging was used to observe the degeneration of cartilage tissue (n=4) after 2 weeks, 4 weeks and 6 weeks. At the same time, the knee joint of 4 miniature pigs without osteoarthritis was used as the control group, and the same observation experiment was carried out. Gross observation, histological analysis, immunohistochemical analysis, and biochemical points were carried out in the left femur medial condyle. Analysis. The correlation between the biochemical tissue components of cartilage and the quantitative data of magnetic resonance cartilage imaging (T1Gd and T2) was analyzed by Pearson correlation analysis. Results: the T1Gd value gradually decreased, the T2 value increased gradually after.4 weeks, and the cartilage tissue surface presented a concave convex.6 week after.6 weeks, and the distribution and content of glycosaminoglycan (GAG) gradually changed with time. Decrease (P0.05), collagen distribution and its anisotropy. However, there was no significant change in the content of collagen at a time point. The content of glycosaminoglycan was positively correlated with T1Gd (r=0.888; P0.001), and was negatively correlated with the T2 value (r=0.865; P0.001). The collagen content was not significantly related to the T1Gd and T2 values of dGEMRIC. Late gadolinium enhanced magnetic resonance cartilage imaging (dGEMRIC) and T2 relaxation time imaging (T2 mapping) were used to observe the degeneration of cartilage tissue after anterior cruciate ligament resection in piglets, which showed that early diagnosis of osteoarthritis was feasible. The third part was based on double turn angle 3DT1mapping to measure the knee joint cartilage of pig animal model. Objective: To evaluate the reproducibility of the 3 T three-dimensional knee cartilage delayed gadolinium enhanced MR imaging (dGEMRIC) in the quantitative analysis of normal pig animal models. Materials and methods: 20 healthy adult Minnesota Dutch miniature pigs were in 7 d for two times 3 T three-dimensional T1 mapping knee dGEMRIC. for the course of movement in the process of acquisition. The artifact, all the images were calibrated strictly. The region of interest in 8 articular cartilage anatomy was analyzed on two images of the knee joint of each pig. The repeatability detection of dGEMRIC based on the T 1 image was evaluated between the 2 regions of interest at each level of the knee joint of each pig, and the T1 image could be resolved in space. The quality of articular cartilage. The reproducibility was evaluated with the same correlation coefficient (ICC) and Bland-Altman diagram. Results: the range of ICC was 0.86 to 0.95, indicating that the cartilage dGEMRIC scan had good repeatability. Using Bland-Altman diagram analysis, the results of dGEMRIC were determined in the longitudinal study, and 95 MS could be used as a result. Conclusion: the three-dimensional delayed gadolinium enhanced 3.0TMR imaging and three-dimensional image calibration of the knee cartilage showed that the cartilage quality was highly repeatable in the early diagnosis of knee arthritis. In the longitudinal study of animal models, the dGEMRIC T1 value of cartilage based on the 3D T1 mapping sequence of two turning angles could be used as a one. A noninvasive technique for evaluating articular cartilage. Main conclusions: (1) cartilage delayed gadolinium enhanced MR imaging (dGEMRIC) of the knee joint can evaluate the articular cartilage. (2) dGEMRIC can produce a high repeatability of the T 1 value in the evaluation of the articular cartilage of the animal model. (3) the establishment of the threshold can determine the significant change of the dGEMRIC results. 4. In longitudinal studies, dGEMRIC can be used to assess cartilage quality.
【学位授予单位】：南京医科大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R684.3;R445.2

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