MR 扩散加权成像诊断膝关节骨关节病髌骨软骨病变的价值

MR 扩散加权成像诊断膝关节骨关节病
髌骨软骨病变的价值
刘斯润 朱天缘 陈汉方 吴荷嘉
【摘要】 目的 探讨MR 扩散加权成像( DWI) 在膝关节软骨早期病变诊断中的临床应用价值。
方法 18 例正常健康志愿者36 个膝关节、10 例骨关节炎( OA) 患者18 个膝关节行常规序列及DWI
序列扫描。测量髌软骨各个感兴趣区的表观扩散系数( ADC) 值, 比较各组间的差异。结果 正常健
康志愿者组36 个髌软骨ADC 均值( ADCav) 为( 7. 8 ±2. 3) × 10 - 4 mm2 / s, 髌软骨上、中、下部的ADC
值分别为( 7. 9 ±2. 3)× 10 - 4 mm2 / s、( 7. 7 ±2. 7)× 10 - 4mm2 / s、( 7. 9 ±2. 5) × 10 - 4 mm2 / s, 之间差异无
统计学意义( F = 0. 050, P = 0. 951) 。OA 患者髌软骨ADCav 为( 10. 5 ±4. 1 )× 10 - 4 mm2 / s, 髌软骨上、
中、下部的ADC 值分别为( 10. 8 ±4. 1) × 10 - 4 mm2 / s、( 10. 4 ±4. 4) × 10 - 4 mm2 / s、( 10. 5 ±4. 2 ) ×
10 - 4mm2 / s, 之间差异无统计学意义( F = 0. 940, P = 0. 910) 。但OA 组的ADC 值明显高于正常组, 两
组间差异有统计学意义( t = - 2. 577, P = 0. 017) , 其中以髌软骨内侧份ADC 值改变最为显著。结论
MR DWI 能发现常规MR 软骨信号尚未改变的更早期软骨病变。
【关键词】 软骨, 关节; 骨关节病; 膝关节; 磁共振成像; 扩散
MR diffusion weighted ima ging study on patella ca rtilage applied to osteoar thr itis of knee joint
LIU Si-run, ZHU Tian-yuan, CHEN Ha n-fang, WU He-jia. Medical Imaging Center, the First Affiliated
Hospital, Jinan University, Gua ngzhou 510630, China.
【Abstra ct 】 Objective To evaluate the clinical significance of quantitative measurement ADC value
of patella cartilage on MR diffusion weighted imaging ( DWI ) . Methods Thirty-six knees of healthy
volunteers and 18 of osteoarthritis( OA) were imaged with routine MR sequences and DWI. The ADC of each
part of patella were measured and compared with each other. Results In healthy volunteers, the ADCav of
patella cartilage was ( 7. 8 ±2. 3)× 10 - 4mm2 / s and the ADCav among superior-middle-inferior portions was
not significantly different ( F = 0. 050, P = 0. 951 ) . The ADCav of superior-middle-inferior portions was
( 7. 9 ±2. 3)× 10 - 4mm2 / s, ( 7. 7 ±2. 7 ) × 10 - 4 mm2 / s, ( 7. 9 ±2. 5 ) × 10 - 4 mm2 / s, respectively. In OA
patients, the ADCav of patella cartilage was ( 10. 5 ±4. 1) × 10 - 4 mm2 / s and the ADCav among superiormiddle-
inferior portions was not significantly different also ( F = 0. 940, P = 0. 910) . The ADCav of superiormiddle-
inferior portions was ( 10. 8 ±4. 1 ) × 10 - 4 mm2 / s, ( 10. 4 ±4. 4 ) × 10 - 4 mm2 / s, ( 10. 5 ±4. 2) ×
10 - 4mm2 / s, respectively. The ADCav of the healthy volunteers was lower than that of the OA group( t = -
2. 577, P = 0. 017) and the medial part showed the most different. Conclusion DWI is a useful method in
detecting early cartilage injury which can not be showed on routine sequences.
【Key wor ds】 Cartilage, articular; Osteoarthropathy; Knee joint; Magnetic resonance imaging;
Diffusion

MR 扩散加权成像诊断膝关节骨关节病--骨格.rar