3.0TMRI扩散加权成像对膝关节软骨退变的诊断价值

Diagnostic value of 3.0T MRI diffusion weighted imaging in cartilage injury of knee joint

目的评价磁共振扩散加权成像(DWI)对骨性关节炎(OA)患者膝关节软骨退变的诊断价值。方法选取先后行膝关节MRI(常规序列及DWI序列)和膝关节镜检查的OA患者53例(男25例,女28例,平均年龄47.6±6.5岁)为研究对象,选取膝关节MRI检查(常规序列及DWI序列)正常者28例(男17例,女11例,平均年龄40.6±6.1岁)正常志愿者组。以膝关节镜下软骨退变分级为金标准,将OA患者软骨退变进行分级。分别测量正常志愿者和OA患者膝关节软骨ADC值并分别观察这两者的彩色ADC图,通过单因素方差分析比较正常志愿者与OA患者组(轻度、重度软骨退变)膝关节软骨平均ADC值之间的差异。结果OA患者膝关节轻度、重度软骨退变平均ADC值均高于正常志愿者组,组间比较差异有统计学意义(P=0.000)。正常志愿者组与轻度软骨退变组、正常志愿者组与重度软骨退变组、轻度软骨退变组与重度软骨退变组软骨平均ADC值分别比较,差异有统计学意义(P=0.000,P=0.013,P=0.017)。相应的彩色ADC图显示膝关节软骨退变的程度及ADC值的变化趋势。结论 DWI序列可以诊断OA患者轻度软骨退变,并且可以区分OA患者膝关节轻度、重度软骨退变程度。

Objective To evaluate the diagnostic value of diffusion weighted imaging（DWI） in the degeneration of knee joint cartilage in patients with osteoarthritis（OA）. Methods Fifty-three OA patients（25 males and 28 females,average age of 47. 6 ± 6. 5 years） who underwent knee MRI examination（conventional sequence and DWI sequence） and knee arthroscopy were selected as the study objects. 28 normal volunteers（17 males and 11 females,average age 40. 6 ± 6. 1 years） underwent MRI examination of knee joint（conventional sequence and DWI sequence） were selected as the study subjects. The grade of cartilage degeneration in OA patients was graded according to the grade of cartilage degeneration under knee arthroscopy as gold standard. The ADC values of knee joint cartilage in normal volunteers and OA patients were measured respectively and the color ADC maps of the two groups were respectively observed.The differences between the mean ADC values of knee articular cartilage in normal volunteers and OA patients（mild and severe cartilage degeneration） were compared by one-way analysis of variance（ANOVA）. Results The average ADC value of mild and severe cartilage degeneration in patients with OA was significantly higher than that of normal volunteers（P = 0. 000）. The average ADC values of cartilage in normal volunteer group and mild degenerative cartilage degeneration group,normal volunteer group and severe degenerative cartilage degeneration group,mild degeneration cartilage degeneration group and severe cartilage degeneration group were significantly different（P = 0. 000,P = 0. 013,P = 0. 017）. The corresponding color ADC map showed the degree of degeneration of knee cartilage and the trend of ADC value.Conclusion The DWI sequence can diagnose mild degeneration of cartilage in patients with OA and can differentiate mild and severe cartilage degeneration in patients with OA.