磁共振T2-mapping成像在早期膝骨关节炎中的应用初探

T2-mapping magnetic resonance imaging in early-stage osteoarthritis of knee joint: a pilot study

目的探讨T2-mapping成像在早期膝骨关节炎(OA)关节软骨退变诊断中的价值。方法选取16名健康志愿者单膝关节、15例OA患者的患膝,行膝关节常规及矢状位T2-mapping成像扫描,处理获得关节软骨的T2-mapping(T2弛豫时间)伪彩图像;测量膝关节髌骨,股骨内侧髁、外侧髁,胫骨内侧髁、外侧髁5处软骨的T2值,并进行统计学分析。分析健康志愿者各关节面软骨浅、深层的T2值差异,并比较志愿者与早期OA患者关节软骨之间的T2值差异。结果①健康志愿者膝关节髌骨,股骨内侧髁、外侧髁,胫骨内侧髁、外侧髁5处软骨浅层的T2值均高于深层的T2值,差异具有统计学意义(P<0.05)。②早期OA患者膝关节髌骨,股骨内侧髁、外侧髁,胫骨内侧髁、外侧髁软骨的T2值均高于健康志愿者相应关节面软骨的T2值,差异具有统计学意义(P<0.05)。结论 T2值可以发现无形态学改变的OA患者软骨内成分变化,表明T2-mapping成像可以为OA的早期诊断提供重要参考依据。

Objective To explore to diagnostic value of T2-mapping imaging in early-stage osteoarthritis of knee joint cartilage degeneration. Methods Conventional and sagittal T2-mapping scans of the knee were undertaken unilaterally in 16 healthy volunteers and 15 patients with osteoarthritis for deriving the pseudo-color images of T2- mapping （T2 relaxation time）. The T2 values of patella cartilage and medial femoral, lateral, medial tibial and lateral condyles were measured for subsequent statistical analysis. The difference of T2 values in superficial and deep carti- lages was analyzed in healthy volunteers, and the distinction in 2＇2 values with regard to the cartilage between healthy volunteers and patients with early-stage OA were compared. Results Healthy volunteers were characterized by sub- stantially higher T2 values of superficial cartilages, i.e. patella cartilage and medial femoral, lateral, medial tibial and lateral condyles than the deep cartilages （all P〈0.05）. In patients with early-stage OA, the ＂1＂2 values of patella carti- lage and medial femoral, lateral, medial tibial and lateral condyles were significantly higher than those in healthy vol- unteers （all P〈0.05）. Conclusion T＇2 values may help diagnose changes in compositions of the cartilage in patients with OA who had no significant morphological change, suggesting that T2-mapping imaging providing the critical refer- ence for the early diagnosis of OA.