磁共振弥散张量成像在评估骨关节炎髌软骨退变中的应用

Application of magnetic resonance DTI imaging in evaluating degeneration of osteoarthritis patella cartilage

目的 分析磁共振弥散张量成像(DTI)在评估骨性关节炎(OA)髌软骨退变中的应用价值。方法 收集2016年10月—2017年10月在内蒙古医科大学第二附属医院就诊并确诊为OA患者35例(OA病例组)及健康成人志愿者35例(健康对照组),行1.5T常规MR及DTI扫描,对髌软骨进行MR分级,并测取髌软骨处的表现弥散系数(ADC)值和部分各向异性分数(FA)值,进行统计学分析,后处理获取髌软骨的DTI伪彩图像。结果 OA病例组ADC值高于健康对照组,且Ⅰ级、Ⅱ级、Ⅲ级和Ⅳ级骨性关节炎的ADC值呈现升高趋势,组间比较差异有统计学意义(χ~2=26.218,P=0.000);OA病例组FA值低于健康对照组,且Ⅰ级、Ⅱ级、Ⅲ级和Ⅳ级骨性关节炎的FA值呈降低趋势,组间比较差异有统计学意义(F=15.879,P=0.000)。正常髌软骨DTI伪彩图连续性好,形态完整,软骨厚度均匀,色阶均匀一致。OA髌软骨变薄、部分甚至全层缺失,连续性差,关节间隙变窄,其内出现混杂色阶。结论 随着OA病例MR级别的升高,ADC值呈上升趋势,FA值呈下降趋势,皆可体现各级病变间差异,评估髌软骨退变程度。磁共振DTI成像是检测OA髌软骨病变的有效检查方法,对临床诊断及治疗具有广阔的应用价值。

Objective To investigate the value of 1.5T magnetic resonance imaging （DTI） imaging in evaluating the degeneration of cartilage of osteoarthritis. Methods A total of 35 patients with OA （OA group） and 35 healthy adult volunteers （Healthy group） were recruited. 1.5T routine MR and DTI scans were performed,and graded by MR. ADC and FA values at the patellar cartilage were measured and statistically analyzed. Obtain DTI pseudo color images of cartilage. Results The ADC values of OA Group were higher than that in healthy group,and ADC value of Ⅰ,Ⅱ,Ⅲ and Ⅳ osteoarthritis showed an elevated trend,and there were statistically significant differences between groups （χ ^2=26.218, P =0.000）; The FA in OA group was lower than that in the healthy group,and the FA value of Grade I to IV decreased,and there were statistically significant differences between groups （ F =15.879, P =0.000）. The normal patellar cartilage in DTI pseudo color map was continuous,complete,with uniform thickness of cartilage and uniform color levels. OA cartilage of patellar cartilage thinning,some or even the whole layer missing,poor continuity,joint clearance narrowed,and with the appearance of mixed color levels. Conclusion With the increase of Level of OA Group,ADC value is increasing,FA value is decreasing,all levels of lesions can be reflected,and the degree of patellar cartilage degeneration is evaluated. Magnetic resonance DTI imaging is an effective method for the detection of OA cartilage lesions,and has broad application value for clinical diagnosis and treatment.