股骨滑车发育不良致髌股关节软骨损伤T2mapping序列定量评估

Quantitative evaluation of the relationship between femoral trochlear dysplasia and the degeneration of the patellofemoral cartilage by using T2mapping

目的采用T2mapping磁共振技术前瞻性定量评估股骨滑车发育不良(FTD)与髌股关节软骨早期损伤的关系及其特点。方法收集2016年1月至2017年12月天津市第一中心医院62例18~45岁存在膝关节疼痛FTD患者(试验组);对照组为相匹配股骨滑车发育正常志愿者。运用软骨T2 mapping序列,分别比较试验组与对照组、年龄<30岁组、年龄≥30岁组、不同股骨滑车分型组中髌骨、股骨滑车内外侧面深浅层软骨T2值差异。结果FTD组浅层股骨滑车外侧面(sFL)(P=0.000)、浅层髌骨外侧面(sPL)(P=0.009)软骨T2值低于对照组;年龄<30岁组中,FTD组浅层股骨滑车外侧面(sFL)(P=0.001)、浅层髌骨外侧面(sPL)(P=0.015)软骨T2值低于对照组;年龄≥30岁组中,FTD组浅层股骨滑车外侧面(sFL)(P=0.035)软骨T2值低于对照组;不同股骨滑车分型组中,B^D型组浅层股骨滑车外侧面(sFL)(P=0.014)、浅层髌骨外侧面(sPL)(P=0.000)、浅层髌骨内侧面(sPM)(P=0.020)软骨T2值最低,而深层股骨滑车内侧面(dFM)(P=0.006)软骨T2值最高;以上差异均有统计学意义(均P<0.05)。结论FTD易引起中青年浅层髌股软骨早期损伤;B^D型FTD能引起更广泛的浅层髌股软骨损伤,并累及软骨深层;损伤表现出浅层软骨失水性改变,深层软骨水肿性表现。

Objective To evaluate the relationship between the femoral trochlear dysplasia(FTD)and the degeneration of the patellofemoral cartilage by using MR T2mapping technique.Methods Sixty two subjects with FTD(aged 18-45 years)were enrolled in Tianjin First Center Hospital from January 2016 to December 2017,the controls which both age and gender were matched.T2mapping scan were aquired for each subject and control.Compare the differences of the T2mapping values for each area between subjects and controls,and compare Dejour types of femoral trochlear in different age groups,respectively.Results The T2mapping value of subjects was significant lower than controls:the superficial-femoral-lateral layer(sFL)(P=0.000)and the superficial-patella-lateral layer(sPL)(P=0.009).In the group of age less than 30 years,the T2mapping value of subjects was significant lower than controls:sFL(P=0.001)and sPL(P=0.015).In group of age greater than 30 years,the T2mapping value of subjects was significant lower than controls:sFL(P=0.035).In difference Dejour types of FTD,the T2mapping value of type B-D was lowest in sFL(P=0.014),sPL(P=0.000),the superficial-patella-medial layer(sPM)(P=0.020)and the the T2mapping value of type B-D was highest in the deep-femoral-medial layer(dFM)(P=0.006).The difference was statistically significant,P<0.05.Conclusion The FTD might cause the early degeneration of patellofemoral cartilage,which significantly appear in the young age;The type B-D of FTD is more likely to cause the wider range of superficial cartilage injure and involved some part of deep layer;the injure shows dehydration change in superficial cartilage and edema in deep layer.