磁共振成像对膝关节移植软骨生物力学指标的前瞻性研究

发布时间：2018-03-26 21:21

本文选题：磁共振　切入点：T2值　出处：《中国人民解放军医学院》2014年硕士论文

【摘要】：目的探讨磁共振T2mapping成像对基质诱导的自体软骨细胞移植（matrix-associated autologous chondrocyte transplantation, MACT）术后移植软骨的评估价值。方法9例接受MACT治疗的膝关节软骨损伤患者（16处软骨损伤），分别在术后1、3、6、12个月进行磁共振T2mapping检查，测量各时间点移植区与正常区软骨全层的T2值。采用配对t检验比较各个时间点移植区与正常区软骨T2值，采用单因素方差分析评估移植区软骨T2值的纵向变化。结果MACT术后1、3、6、12月移植区软骨的T2值分别为82.00±17.73ms、71.56±12.33ms、57.30±6.13ms和49.74±5.15ms。术后各个时间点移植区T2值均大于正常区，1、3月组有显著差异（P0.05），6、12月组无显著差异（P值分别为0.065、0.204）。术后1月和6月、1月和12月、3月和6月、3月和12月移植区T2值两两比较，差别均有统计学意义（P0.05），1月和3月、6月和12月差异无统计学差异（P分别为0.185、0.527）；对于正常区，各随访时间T2值无明显统计学差异（P＞0.05)。结论磁共振T2mapping成像能够无创、动态地监测移植软骨的修复过程，可作为评估软骨修复状态的重要手段。目的探讨磁共振软骨延迟增强成像（delayed gadolinium-enhanced MRI ofcartilage，dGEMRIC）对MACT后移植软骨的评估价值。方法9例接受MACT治疗的膝关节软骨损伤患者（16处软骨损伤），于术后1、3、6、12个月分别行dGEMRIC，测量各时间点打药前、后移植区及正常区软骨全层的T1值，，计算R1(R1=1/T1post-1/T1pre)。采用配对t检验比较各个时间点移植区与正常区软骨的R1值，采用单因素方差分析评估移植区软骨R1值的纵向变化。结果MACT术后1、3、6、12月移植区的R1值分别为2.28±0.38s-1，1.93±0.31s-1，1.53±0.36s-1，1.08±0.15s-1。术后各时间点移植区R1值均明显大于正常区（P＜0.05），但随着时间延长，移植区软骨R1值逐渐接近正常软骨。术后1月与6月、1月与12月、3月与6月、3月与12月、6月与12月移植区R1值两两比较差异均有统计学意义，（P＜0.05）；1月与3月移植区R1值差异无统计学意义（P=0.55）；对于正常区，各随访时间R1值无明显统计学差异（P0.05)。结论dGEMRIC技术可以定量反映移植软骨生化成分修复，对软骨移植的随访具有重要的临床应用价值。
[Abstract]:Objective To evaluate the value of magnetic resonance T2mapping imaging ( MACT ) in the evaluation of matrix - associated chondrocytes transplantation ( MACT ) .

Methods Nine patients with knee joint cartilage injury treated with MACT were examined by magnetic resonance T2mapping at 1,3,6,12 months postoperatively . The T2 values were measured at each time point implantation area and normal area cartilage . Using paired t test , the value of T2 in each time point transplantation area and normal area was compared . A single factor analysis was used to evaluate the longitudinal changes of T2 value in the transplantation area .

Results The T2 values of 1 , 3 , 6 and 12 months after MACT were 82.00 卤 17.73 ms , 71.56 卤 12.33ms , 57.30 卤 6.13ms and 49.74 卤 5.15ms , respectively . There was no significant difference between the two groups ( P0.05 ) .
There was no significant difference in the follow - up time ( P > 0.05 ) .

Conclusion Magnetic resonance T2mapping can be used as an important means to assess the state of cartilage repair without invasive and dynamic monitoring of the repair process of transplanted cartilage .

Objective To evaluate the value of delayed enhancement - enhanced MRI of cartilage ( dgeRIC ) in the evaluation of cartilage after MACT .

Methods Nine patients with knee joint cartilage injury treated with MACT were measured at 1 , 3 , 6 and 12 months after operation , and the T1 values of the whole layer of cartilage were measured before and after each time point . The R1 values of each time point transplantation area and normal area cartilage were compared by paired t test . The longitudinal changes of the value of the cartilage R1 in the transplantation area were assessed by single factor analysis .

Results The R1 values of 1 , 3 , 6 and 12 months after MACT were 2 . 28 卤 0 . 38s - 1 , 1 . 93 卤 0 . 31 s - 1 , 1 . 53 卤 0 . 36 s - 1 , 1.08 卤 0 . 15 s - 1 .
There was no significant difference in the value of R1 between January and March ( P = 0.55 ) .
For the normal area , there was no significant difference in the value of R1 in the follow - up time ( P0.05 ) .

Conclusion The method can quantitatively reflect the repair of the biochemical components of the transplanted cartilage , and has important clinical application value for the follow - up of the cartilage transplantation .

【学位授予单位】：中国人民解放军医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R687.4

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