磁共振压缩感知三维成像对膝关节炎易损区域软骨及软骨下骨髓水肿的研究

Analysis of magnetic resonance compression sensing three-dimensional imaging on cartilage damageand subchondral bone marrow edema in vulnerable areas of knee arthritis

目的 通过磁共振cs3D_VIEW_PD_SPAIR成像分析KOA软骨损伤分级与软骨下骨髓水肿程度的相关性。方法 选取关节外科患者65例,进行膝关节磁共振检查,采用Phillip 3.0 T磁共振扫描仪,压缩感知(CS)技术基于质子密度加权的三维各向同性快速自旋回波序列(cs3D_VIEW_PD_SPAIR)及常规PDW_SPAIR序列扫描,两名医师主观评价2组序列图像;通过膝关节不同分区选取常见损伤区域,在cs3D_VIEW_PD_SPAIR序列图像观察软骨、软骨下骨髓水肿形态及信号改变,并按膝关节MR(MOAKS)评分系统,选取65例中的58例易损区域,对软骨分级及骨髓水肿程度进行相关性分析。结果 cs3D_VIEW_PDW_SPAIR序列与常规PDW_SPAIR序列图像质量主观评分有差异性(χ2=60.836,P<0.05);膝关节损伤以股骨内侧中央区、滑车区、髌骨及胫骨内侧中央区为主;软骨损伤分级程度与软骨下骨髓水肿程度呈正相关(χ2=14.409,Somers d系数=0.278,Kendall等级相关系数=0.278,P<0.05),软骨损伤分级越高,软骨下骨髓水肿越明显。结论 cs3D_VIEW_PDW_SPAIR序列图像观察软骨及软骨下骨髓水肿效果更佳;膝关节损伤部位有一定的规律性;膝关节不同程度软骨损伤与软骨下骨髓水肿相互作用。

Objective To analyze the correlation between the cartilage injury grade of knee osteoarthritis and the degree of subchondral bone marrow edema through magnetic resonance cs3D_VIEW_PD_SPAIR imaging.Method 65 patients of joint surgery were collected for magnetic resonance examination of knee joint.Phillip3.0T magnetic resonance scanner,and compressed sensing(CS)technology based on proton density weighted three-dimensional isotropic fast spin echo sequence(cs3D_VIEW_PD_SPAIR)and conventional PDW SPAIR sequence scanning were used.Two physicians subjectively evaluated two sets of sequence images.The common injury areas were selected through different zones of the knee joint,and cs3D_VIEW_PD_SPAIR sequence images were used to observe the morphology and signal changes of cartilage and subchondral bone marrow edema.According to the knee joint MR(MOAKS)scoring system,58 cases of vulnerable areas were selected from 65 cases,and the correlation between cartilage grading and bone marrow edema was analyzed.Results The subjective score of image quality of cs3D_VIEW_PDW_SPAIR sequence and conventional PDW SPAIR sequence was different(χ2=60.836,P<0.05).The knee joint injuries were mainly in the medial central area of femur,trochlear area,patella and medial central area of tibia.The degree of cartilage injury was positively correlated with the degree of subchondral bone marrow edema(χ2=14.409,Somersd coefficient=0.278,Kendall grade correlation coefficient=0.278,P<0.05),the higher the cartilage injury grade,the more obvious the subchondral bone marrow edema.Conclusion cs3D_VIEW_PDW_SPAIR sequence images showed better effect on cartilage and subchondral bone marrow edema.There is certain regularity in the injured part of knee joint.Different degrees of cartilage injury of knee joint interact with subchondral bone marrow edema.