定量T2 mapping评估前交叉韧带重建术后6个月、12个月移植物成熟度变化并与临床评分相关性

Quantitative T2 mapping to Assess Changes in Graft Maturity at 6 and 12 Months After Anterior Cruciate Ligament Reconstruction

目的利用T2 mapping功能磁共振定量检测前交叉韧带重建术(ACLR)后6个月、12个月移植物重塑状态并与临床评分相关性。方法前瞻性搜集行ACLR的患者40例,ACLR后患者在6个月、12个月都接受3.0 T常规MRI及T2 mapping扫描,测得术后移植物关节内段整体及其三个分段(近、中、远)T2值。术后6个月、12个月使用国际膝关节文献委员会膝关节评分(IKDC)进行临床功能评分。使用独立样本t检验用于分析术后6个月、12个月的关节三段以及关节内段整体T2值之间的差异。关节内段三段采用LSD-t法进行两两比较。采用Spearman相关分析评估移植物关节内段T2值与临床评分相关性。结果前交叉韧带移植物整体关节内段及其三个分段(近、中、远)的T2值在6个月到12个月内明显下降(P值均<0.001)。术后6个月关节内段的近段的T2值较中段及远段高(P=0.026和P=0.001),术后12个月,关节内段的近段的T2值较远段高(P<0.001)。术后6个月移植物T2值与IKDC评分呈中度负相关(r=-0.508,P=0.001),术后12个月移植物T2值与IKDC评分呈中度负相关(r=-0.559,P<0.001)。结论T2 mapping可以检测ACLR术后6个月到12个月移植物关节内段成熟度变化,具有潜在临床应用价值。

Objective Quantification of graft remodeling status at 6 and 12 months after anterior cruciate ligament re-construction(ACLR)using T2 mapping functional magnetic resonance and correlation with clinical scores.Methods Patients who underwent ACLR between August 2020 and October 2021(n=40)were collected prospectively,and after ACL reconstruction patients underwent 3.0T conventional MRI and T2 mapping scans at 6 and 12 months after surgery to meas-ure the T2 values of the intra-articular segment of the graft and its three segments(proximal,middle and distal)after sur-gery.Independent samples t-tests were used to analyze the differences between the three segments and the intra-articular segment T2 values at 6 and 12 months post-operatively.Two-by-two comparisons were made using the LSD-t method for the three segments of the intra-articular segment.The International Knee Documentation Committee knee score(IKDC)was used for clinical function scores at 6 and 12 months postoperatively.Results The T2 values of the overall intra-articular segment of the ACL graft and its three segments(proximal,middle and distal)decreased significantly from 6 to 12 months(P<0.001).The proximal segment of the intra-articular segment had higher T2 values than the middle and distal segments at 6 months postoperatively(P=0.026 and P=0.001),and the proximal segment of the intra-articular segment had higher T2 values than the distal segment at 12 months postoperatively(P<0.001).There was a moderate negative correlation be-tween graft T2 values and IKDC scores at 6 months postoperatively(r=-0.508,P=0.001)and at 12 months postopera-tively(r=-0.559,P<0.001).Conclusion T2 mapping can detect changes in graft intra-articular segment maturity from 6 months to 12 months after ACLR and has potential clinical application.