磁共振T_1ρ和T_2-mapping定量技术评估膝关节Ⅰ型胶原蛋白基质置入术后软骨修复
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摘要
目的探讨MRI T_1ρ和T_2-mapping成像技术定量评估膝关节Ⅰ型胶原蛋白基质置入术后软骨修复的应用价值。方法纳入20例膝关节Ⅰ型胶原蛋白置入术后患者(24处软骨损伤)作为试验组,并纳入20名健康志愿者作为对照组,试验组在术后3、6及12个月进行随访,所有患者均行MR检查,检查序列包括常规序列及T_1ρ、T_2-mapping序列。扫描结束后,通过工作站后处理,测量术区软骨的T_1ρ和T_2值。利用方差分析比较试验组各个时间段与对照组的T_1ρ和T_2值,用Pearson相关分析分析两者与术后修复时间的相关性。结果Ⅰ型胶原蛋白置入术后3个月,试验组软骨术区的T_1ρ和T_2值均显著高于正常对照组(P<0.05);术后6个月试验组术区T_1ρ和T_2值明显降低,但与正常对照组相比差异具有统计学意义(P<0.05);术后12个月术区T_1ρ和T_2值持续降低,与对照组相比,差异无统计学意义(P>0.05)。T_1ρ和T_2值与术后时间无明显相关性,术后3个月与6个月,以及术后6个月与12个月相比,P值分别为0.827、0.105、0.35、0.332。结论 MRI T_1ρ和T_2-mapping定量技术可通过反映术区软骨内生化成分的变化,动态追踪术后软骨的修复情况,T_1ρ和T_2-mapping均为临床提供有效的评估手段,具有较高的诊断价值。
Objective To explore the application value of MR T_1ρ and T_2-mapping imaging in quantitative assessment of Cartilage repair in patients with type I collagen matrix implants in the knee joint. Methods Twenty patients with type I collagen implantation(24 cartilage injury) were enrolled as the experimental group and twenty healthy volunteers were enrolled as control group.The patients in the experimental group were followed up after the operation in the third,sixth and twelfth month.All patients and volunteers were checked by MR and and the sequence included T_1ρ and T_2-mapping.Through the workstation post-processing,the quantitative parameters of T_1ρ and T_2 value were calculated.The T_1ρ and T_2 value were compared between the control group and the experimental group at each time point by variance analysis.The correlation between T_1ρ and T_2 value and postoperative repair time were analyzed using Person correlation analysis. Results In the 3 months after surgery,T_1ρ and T_2 value of patients were significantly higher than the control group(P<0.05).In the 6 months after surgery,there was still diacrepancy in patients compared with volunteers although the value decreased significantly(P<0.05).In the 12 months after surgery,the T_1 and T_2 values in the operative area decreased continuously,and the difference was not statistically significant(P>0.05) compared with the control group.There was no obvious relativity between T_1ρ and T_2 value and the postoperative time(P value were respectively 0.827、0.105、0.35、0.332). Conclusion MR T_1ρ and T_2-mapping can monitor the situation of cartilage repair dynamically through reflecting the changes in biochemical components of cartilage.T_1ρ and T_2-mapping are effective tools worth using in clinical evaluation.
Objective To explore the application value of MR T_1ρ and T_2-mapping imaging in quantitative assessment of Cartilage repair in patients with type I collagen matrix implants in the knee joint. Methods Twenty patients with type I collagen implantation(24 cartilage injury) were enrolled as the experimental group and twenty healthy volunteers were enrolled as control group.The patients in the experimental group were followed up after the operation in the third,sixth and twelfth month.All patients and volunteers were checked by MR and and the sequence included T_1ρ and T_2-mapping.Through the workstation post-processing,the quantitative parameters of T_1ρ and T_2 value were calculated.The T_1ρ and T_2 value were compared between the control group and the experimental group at each time point by variance analysis.The correlation between T_1ρ and T_2 value and postoperative repair time were analyzed using Person correlation analysis. Results In the 3 months after surgery,T_1ρ and T_2 value of patients were significantly higher than the control group(P<0.05).In the 6 months after surgery,there was still diacrepancy in patients compared with volunteers although the value decreased significantly(P<0.05).In the 12 months after surgery,the T_1 and T_2 values in the operative area decreased continuously,and the difference was not statistically significant(P>0.05) compared with the control group.There was no obvious relativity between T_1ρ and T_2 value and the postoperative time(P value were respectively 0.827、0.105、0.35、0.332). Conclusion MR T_1ρ and T_2-mapping can monitor the situation of cartilage repair dynamically through reflecting the changes in biochemical components of cartilage.T_1ρ and T_2-mapping are effective tools worth using in clinical evaluation.
引文
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6王伟,梁文,慕革非,等.磁共振T1ρ与T2mapping技术定量检测腰椎间盘退变的初步研究[J].实用医学杂志,2013,29:2692-2694.
7 Kim MS,Koh IJ,Choi YJ,et al.Collagen Augmentation Improves the Quality of Cartilage Repair After Microfracture in Patients Undergoing High Tibial Osteotomy[J].Am J Sports Med,2017,45:1845-1855.
8 Duan W,Da H,Wang W,et al.Experimental study of tissue engineered cartilage construction using oriented scaffold combined with bone marrow mesenchymal stem cells in vivo[J].Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi,2013,27:513-519.
9 Roessler PP,Pfister B,Gesslein M,et al.Short-term follow up after implantation of a cell-free collagen type I matrix for the treatment of large cartilage defects of the knee[J].Int Orthop,2015,39:2473-2479.
10陈玲,梁文,金显跃,等.MR T1ρ成像技术早期诊断膝骨性关节炎早期软骨损伤[J].中国医学影像技术,2015,13:706-708.
11陈其春,邹月芬,王德杭,等.磁共振T2-mapping成像在膝关节早期骨性关节炎中的应用[J].临床放射学杂志,2012,31:81-85.
12吕英茹,陈爽,蒋胜洪,等.不同年龄段膝关节软骨T2弛豫时间测量及临床意义的初步探讨[J].临床放射学杂志,2011,30:1170-1173.
13徐寿良,俞逵仑,史新平,等.膝关节软骨MR成像的技术探讨[J].实用放射学杂志,2005,21:1094-1096.
14高峰,张宗军,唐文伟,等.膝关节软骨磁共振T2及T2star弛豫时间图成像的初步研究[J].临床放射学杂志,2013,32:1305-1310.
15苏刚,戴雪松,乐剑平,等.膝关节基质诱导自体软骨细胞移植术:软骨修复的磁共振评价[J].临床放射学杂志,2016,35:914-918.
2陈敏,徐贤,韩邵军,等.磁共振T2mapping成像对移植软骨的评估价值[J].中国医学科学院学报,2014,36:86-91.
3冷晓明,韩晓蕊,徐玲,等.磁共振T1ρ成像定量评估股骨头坏死患者软骨损伤[J].中国医学影像技术,2017,33:93-96.
4 Nieminen MT,T9yrs J,Rieppo J,et al.Quantitative MR microscopy of enzymatically degraded articular cartilage[J].Magn Reson Med,2000,43:676-681.
5 Vira S,Ramme AJ,Chapman C,et al.Juvenile Particulate Osteochondral Allograft for Treatment of Osteochondral Lesions of the Talus:Detection of Altered Repair Tissue Biochemical Composition Using 7 Tesla MRI and T2Mapping[J].J Foot Ankle Surg,2017,56:26-29.
6王伟,梁文,慕革非,等.磁共振T1ρ与T2mapping技术定量检测腰椎间盘退变的初步研究[J].实用医学杂志,2013,29:2692-2694.
7 Kim MS,Koh IJ,Choi YJ,et al.Collagen Augmentation Improves the Quality of Cartilage Repair After Microfracture in Patients Undergoing High Tibial Osteotomy[J].Am J Sports Med,2017,45:1845-1855.
8 Duan W,Da H,Wang W,et al.Experimental study of tissue engineered cartilage construction using oriented scaffold combined with bone marrow mesenchymal stem cells in vivo[J].Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi,2013,27:513-519.
9 Roessler PP,Pfister B,Gesslein M,et al.Short-term follow up after implantation of a cell-free collagen type I matrix for the treatment of large cartilage defects of the knee[J].Int Orthop,2015,39:2473-2479.
10陈玲,梁文,金显跃,等.MR T1ρ成像技术早期诊断膝骨性关节炎早期软骨损伤[J].中国医学影像技术,2015,13:706-708.
11陈其春,邹月芬,王德杭,等.磁共振T2-mapping成像在膝关节早期骨性关节炎中的应用[J].临床放射学杂志,2012,31:81-85.
12吕英茹,陈爽,蒋胜洪,等.不同年龄段膝关节软骨T2弛豫时间测量及临床意义的初步探讨[J].临床放射学杂志,2011,30:1170-1173.
13徐寿良,俞逵仑,史新平,等.膝关节软骨MR成像的技术探讨[J].实用放射学杂志,2005,21:1094-1096.
14高峰,张宗军,唐文伟,等.膝关节软骨磁共振T2及T2star弛豫时间图成像的初步研究[J].临床放射学杂志,2013,32:1305-1310.
15苏刚,戴雪松,乐剑平,等.膝关节基质诱导自体软骨细胞移植术:软骨修复的磁共振评价[J].临床放射学杂志,2016,35:914-918.