本文選題：磁共振 + T2值　； 參考：《中國(guó)人民解放軍醫(yī)學(xué)院》2015年碩士論文

【摘要】：目的 使用3.0T MRI評(píng)估基質(zhì)誘導(dǎo)自體軟骨移植(matrix-associated autologous chondrocyte transplantation,MACT)術(shù)后1年移植軟骨的形態(tài)學(xué)表現(xiàn),并與臨床評(píng)分系統(tǒng)作相關(guān)性分析。方法納入9例(12膝12處移植軟骨)MACT術(shù)后患者,于術(shù)后1年進(jìn)行磁共振掃描檢查,對(duì)影像表現(xiàn)采用軟骨修復(fù)組織MR觀察評(píng)分系統(tǒng)(MOCART評(píng)分系統(tǒng)),臨床癥狀采用Lysholm評(píng)分,并對(duì)兩者做相關(guān)性分析。同時(shí),采用組內(nèi)相關(guān)系數(shù)(ICC)對(duì)不同觀察者間的評(píng)估差異度做可靠性分析。結(jié)果MOCATR評(píng)分結(jié)果顯示,術(shù)后1年所有移植軟骨中,50%的修復(fù)區(qū)表現(xiàn)為完全填充；66.7%的修復(fù)區(qū)移植軟骨與鄰近軟骨信號(hào)強(qiáng)度一致或基本一致；75%修復(fù)區(qū)與鄰近正常軟骨邊緣完全整合；66.7%修復(fù)區(qū)軟骨下骨板和軟骨下骨完整。觀察者間結(jié)果可靠性ICC評(píng)分：ICC值=0.862(ICC值0.81表示可信度良好)。同時(shí)對(duì)患者進(jìn)行臨床Lysholm評(píng)分,評(píng)分結(jié)果：78.42±13.70。術(shù)后1年MOCART評(píng)分與臨床Lysholm評(píng)分相關(guān)性分析結(jié)果：分類(lèi)變量“軟骨缺損修復(fù)與填充程度”與Lysholm評(píng)分相關(guān)系數(shù)0.654,P值0.02,兩者呈明顯的正相關(guān),具有統(tǒng)計(jì)學(xué)意義。“修復(fù)組織結(jié)構(gòu)”、“修復(fù)組織信號(hào)強(qiáng)度”、“軟骨下骨改變”等其他分類(lèi)變量與Lysholm評(píng)分均未見(jiàn)明顯的相關(guān)性。結(jié)論移植軟骨的高分辨磁共振形態(tài)學(xué)評(píng)估,是MACT術(shù)后隨訪觀察移植軟骨的有效手段,且與臨床癥狀有一定的相關(guān)性。目的評(píng)估磁共振T2mapping成像技術(shù)在基質(zhì)誘導(dǎo)自體軟骨移植(MACT)術(shù)后移植軟骨的定量分析價(jià)值。方法 納入6例(9膝9處移植軟骨)MACT術(shù)后患者,分別在術(shù)后3月、6月及12月進(jìn)行磁共振動(dòng)態(tài)隨訪檢查,測(cè)量軟骨修復(fù)區(qū)與正常對(duì)照區(qū)深淺兩個(gè)區(qū)域及全層T2值,橫向比較同一時(shí)間點(diǎn)同一膝關(guān)節(jié)修復(fù)區(qū)與正常區(qū)T2值差異,縱向評(píng)估術(shù)后3、6、12月修復(fù)區(qū)T2值的變化。結(jié)果MACT術(shù)后3、6月移植區(qū)全層T2值分別為(68.32±10.36)ms,(58.11±6.68)ms,顯著高于鄰近正常軟骨(P0.05),術(shù)后12月修復(fù)區(qū)全層T2值(46.01±2.15)ms,較正常對(duì)照區(qū)無(wú)明顯統(tǒng)計(jì)學(xué)差異(P=0.063)。術(shù)后6、12個(gè)月修復(fù)區(qū)深淺層T2值比較：6個(gè)月淺層T2值(59.21±7.45)ms,深層(56.89±6.13)ms；12個(gè)月淺層T2值(49.78±2.46)ms,深層(42.23±4.52)ms。術(shù)后6、12個(gè)月淺層軟骨T2值均顯著高于深層(P均0.05)。術(shù)后3個(gè)月修復(fù)區(qū)淺層T2值(68.42±10.33)ms,深層(68.25±10.51)ms,深淺層未見(jiàn)明顯統(tǒng)計(jì)學(xué)差異；術(shù)后3、6、12個(gè)月修復(fù)區(qū)深淺層T2值縱向變化均有統(tǒng)計(jì)學(xué)差異(P均0.05)。結(jié)論T2mapping是評(píng)估移植軟骨膠原含量的重要指標(biāo),對(duì)移植軟骨分層定量評(píng)價(jià),可動(dòng)態(tài)觀察移植軟骨的修復(fù)過(guò)程。MACT術(shù)后磁共振T2mapping成像可作為評(píng)估關(guān)節(jié)軟骨修復(fù)效果的重要依據(jù)。
[Abstract]:Objective to evaluate the morphologic features of grafted cartilage one year after matrix-associated autologous chondrocyte transplantation with matrix induced autologous cartilage transplantation using 3.0T MRI, and to analyze the correlation with clinical scoring system. Methods 9 patients with 12 knees and 12 grafts of cartilage grafted after MACT were examined by magnetic resonance imaging (MRI) one year after operation. The imaging findings were assessed by Mr observation system of cartilage repair tissue and Lysholm scoring system for clinical symptoms. And the correlation between the two is analyzed. Intra-group correlation coefficient (ICC) was used to analyze the reliability of the difference between different observers. Results the MOCATR score showed that, One year after operation, 50% of the repair areas of all transplanted cartilage showed that 66.7% of the repair areas were completely filled with the adjacent cartilage. The signal intensity of the transplanted cartilage was the same as that of the adjacent cartilage. 75% of the repair areas were fully integrated with the adjacent normal cartilage edge. 66.7% of the soft areas were completely integrated with the adjacent normal cartilage margins. The subosseous bone plate and subchondral bone were intact. The reliability ICC score of the inter-observer results was 0.862 and 0.81 indicating that the reliability was good. At the same time, the patients were evaluated with clinical Lysholm score: 78.42 鹵13.70. 1 year after operation, the correlation between MOCART score and clinical Lysholm score: the correlation coefficient between the classification variable "degree of cartilage defect repair and filling" and Lysholm score was 0.654g P value 0.02, which was significantly positive correlation with statistical significance. There was no significant correlation between Lysholm score and other classification variables, such as "repair tissue structure", "repair tissue signal intensity", "subchondral bone change" and so on. Conclusion the morphologic evaluation of graft cartilage with high resolution magnetic resonance imaging is an effective method to observe the graft cartilage after MACT, and has some correlation with clinical symptoms. Objective to evaluate the quantitative value of magnetic resonance (T2mapping) imaging in cartilage grafts after matrix induced autologous cartilage transplantation. Methods six patients with 9 knees and 9 transplanted cartilage grafts after MACT were examined by dynamic magnetic resonance imaging (MRI) in 3 months, 6 months and 12 months, respectively. T2 values were measured in the deep and shallow areas of the cartilage repair area and the normal control area, as well as in the whole layer. The T _ 2 values of the same knee repair area and normal area were compared at the same time point, and the changes of T _ 2 value in the repair area 3 ~ 6 and 12 months after operation were evaluated longitudinally. Results the T _ 2 values of the whole graft area in 3 and 6 months after MACT were 68.32 鹵10.36 Ms and 58.11 鹵6.68 msrespectively, which were significantly higher than those in the adjacent normal chondrocytes (P0.05). The T _ 2 value of the whole layer in the repair area was 46.01 鹵2.15msat 12 months after MACT, and there was no significant difference compared with the normal control area (P0.063ms). At 6 and 12 months after operation, the T 2 values of the deep and shallow layers were 59.21 鹵7.45 msand 56.89 鹵6.13 Ms, 49.78 鹵2.46 msand 42.23 鹵4.52 msrespectively. The T 2 value of superficial cartilage at 6 and 12 months after operation was significantly higher than that in deep layer (P < 0.05). There was no significant difference in T _ 2 value of the superficial layer and deep layer (68.25 鹵10.51ms) and in the deep layer (68.42 鹵10.33m / s), but there was no significant difference in the depth and shallow layer between the deep and shallow layers 3 months after operation and 12 months after operation (P < 0.05). Conclusion T2mapping is an important index to evaluate the collagen content of allograft cartilage. The quantitative evaluation of graft cartilage stratification can dynamically observe the repair process of transplanted cartilage. Mr T2mapping imaging after MACT can be used as an important basis for evaluating the effect of articular cartilage repair.
【學(xué)位授予單位】：中國(guó)人民解放軍醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R445.2;R687.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 張君;徐賢;李雪;陳敏;董天明;左盼利;安寧豫;;基質(zhì)誘導(dǎo)的自體軟骨移植術(shù)后3T磁共振T2mapping成像對(duì)移植軟骨的分層定量評(píng)價(jià)[J];南方醫(yī)科大學(xué)學(xué)報(bào);2015年01期

，

本文編號(hào)：1907415