核磁共振T2-star-mapping成像软骨定量分析在膝关节骨性关节炎诊断中的临床应用研究

发布时间：2018-05-09 15:57

本文选题：膝关节骨性关节炎 + 关节软骨　；参考：《宁夏医科大学》2015年硕士论文

【摘要】：目的探讨核磁共振T2-star-mapping成像软骨定量分析技术对膝关节骨性关节炎诊断中的临床意义。方法选取正常志愿者22例(年龄20~25岁,均为女性)共22个膝关节为对照组;临床诊断的轻度OA患者20例、中度OA患者20例、重度OA患者20例(均为女性)共60个膝关节作为病例组。采用GE 3.0T磁共振扫描仪,行膝关节T2-starmapping成像,获得股骨内侧髁关节面、股骨外侧髁关节面、胫骨内侧髁关节面、胫骨外侧髁关节面、髌骨软骨面的T2*值,比较各组T2*值的差异。获取单髁关节置换术及全膝关节置换术后的离体软骨标本,经Collins病理学分级后比较各级T2*值的差异。结果1.正常对照组关节软骨的平均T2*值为(21.74±3.82)ms;轻度OA组关节软骨的平均T2*值为(27.55±5.48)ms;中度OA组关节软骨的平均T2*值为(35.01±8.83)ms;重度OA组关节软骨的平均T2*值为(41.14±14.20)ms。2.轻度OA组、中度OA组及重度OA组关节软骨的平均T2*值均较正常对照组关节软骨T2*值明显升高,差异有显著性统计学意义(P0.01)。3.各OA组膝关节的五个不同部位软骨的T2*值均较正常组升高,随着关节软骨退变程度加重,对应的T2*值随之升高,差异有统计学意义(P0.05)。4.软骨退变T2*值与Collins病理分级对照,随着软骨退变Collins病理学分级升高,对应的T2*值逐渐升高,T2*值随软骨退变程度的增高而明显升高,各级之间均存在显著的统计学差异。结论1.随着关节软骨退变程度加重,对应的T2*值随之升高。提示磁共振T2-starmapping成像软骨定量分析可以作为诊断早期OA的检查方法。2.软骨退变Collins病理学分级升高,对应的T2*值逐渐升高,T2*值随软骨退变程度的增高而明显升高。关节软骨T2*值的改变为OA的诊断提供了一种重要的检查方法。3.磁共振T2-star-mapping成像软骨定量分析作为一种新的软骨磁共振生理性成像技术,通过量化分析微观结构的关节软骨内部组织成分的变化,有利于在关节软骨发生形态学改变之前,即能在早期发现关节软骨内病变,对早期膝关节软骨损伤的诊断和监测具有较高的临床应用价值。
[Abstract]:Objective to investigate the clinical significance of quantitative analysis of cartilage with T2-star-mapping imaging in the diagnosis of knee osteoarthritis. Methods 22 normal volunteers (aged 20 to 25 years old, all female) were selected as control group, 20 patients with mild OA, 20 patients with moderate OA, 20 patients with mild OA and 20 patients with moderate OA were selected as control group. Twenty patients with severe OA (all female) had 60 knee joints as the case group. The T 2 * values of medial femoral condyle articular surface, lateral femoral condyle articular surface, medial tibial condyle articular surface, lateral tibial condyle articular surface and patellar cartilage face were obtained by GE 3.0T magnetic resonance scanner. The specimens of isolated cartilage were obtained after single condylar arthroplasty and total knee arthroplasty. The differences of T 2 * values between different levels were compared by Collins pathological grading. Result 1. The average T2 * value of articular cartilage was 21.74 卤3.82 Ms in normal group, 27.55 卤5.48 Ms in mild OA group, 35.01 卤8.83 Ms in moderate OA group and 41.14 卤14.20 ms.2ms. in severe OA group. The mean T2 * value of articular cartilage in mild OA group, moderate OA group and severe OA group was significantly higher than that in normal control group (P < 0.01). Compared with the normal group, the T2 * value of the five different parts of articular cartilage in each OA group was higher than that of the normal group. With the degeneration of articular cartilage, the corresponding T2 * value of the articular cartilage increased, and the difference was statistically significant (P 0.05. 4). Compared with the pathological grade of Collins, the T2 * value of cartilage degeneration increased gradually with the increase of Collins pathological grade of cartilage degeneration, and the T2 * value increased obviously with the increase of cartilage degeneration degree. There were significant statistical differences between different grades. Conclusion 1. With the degeneration of articular cartilage, the corresponding T 2 * value increased. The results suggest that quantitative analysis of cartilage in T2-starmapping imaging can be used as a diagnostic method for early OA. The pathological grade of degenerative cartilage Collins increased, and the corresponding T 2 * value gradually increased with the increase of cartilage degeneration degree. The change of T 2 * value of articular cartilage provides an important method for the diagnosis of OA. Quantitative analysis of cartilage with magnetic resonance imaging (T2-star-mapping), as a new technique of magnetic resonance physiologic imaging of cartilage, is beneficial to the morphological changes of articular cartilage by quantitative analysis of the internal tissue components of articular cartilage with microstructure. That is, early detection of articular cartilage lesions, early diagnosis and monitoring of knee cartilage injury has a high clinical value.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R684.3

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