软骨延迟增强磁共振成像对基质诱导的自体软骨细胞移植术后移植软骨的纵向评估

Longitudinal evaluation of reparative cartilage after matrix-associated autologous chondrocyte implantation with delayed gadolinium-enhanced MRI of the cartilage

目的利用软骨延迟增强磁共振成像(dGEMRIC)技术评估基质诱导的自体软骨细胞移植(MACI)术后移植软骨的GAG分层分布特点。方法 7例MACI术后患者(14处软骨缺损)在术后3、6、12个月进行dGEMRIC检查,测量正常软骨和移植软骨的全层和深浅层△R1值。各时间点正常软骨和移植软骨△R1值的比较采用配对t检验。各时间点间移植软骨的△R1值变化采用单因素方差分析。结果 MACI术后各时间点正常软骨全层△R1值均小于移植软骨△R1值(P均<0.05)。MACI术后各时间点移植软骨深层△R1值小于浅层△R1值,差异具有统计学意义(P均<0.05)。MACI术后3个月与6个月移植软骨△R1值的比较不具有统计学意义(P均>0.05),而术后6个月移植软骨△R1值明显大于12个月移植软骨△R1值,且差异具有统计学意义(P均<0.05)。结论 dGEMRIC技术可作为无创性评估移植软骨的修复过程的有效手段。

Objective To estimate zonal variation of GAG content in reparative cartilage after matrix associated autologous chondrocyte implantation（MACI） using delayed gadolinium-enhanced magnetic resonance imaging of the cartilage（d GEMRIC）.Methods Seven patients（14 cartilage defects） undergoing MACI were recruited for examination with d GEMRIC at 3, 6, and 12 months after the procedure to calculate global and zonal longitudinal relaxivity（△R1） of the normal cartilage and reparative cartilage. Results The mean △ R1 values of normal cartilage were significantly lower than those of reparative cartilage after MACI. A significant decrease was noted in the mean △R1 values from the deep layer to the superficial layer in the reparative cartilage at the 3 examinations. The △R1 values of the reparative cartilage showed no significant variation between 3 months and 6 months, but a significant decrease in the △R1 values occurred at 12 months. Conclusion d GEMRIC is feasible to assess cartilage repair noninvasively following MACI.