本文選題：膝關(guān)節(jié)骨性關(guān)節(jié)炎 + 關(guān)節(jié)軟骨　； 參考：《寧夏醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的探討核磁共振T2-star-mapping成像軟骨定量分析技術(shù)對膝關(guān)節(jié)骨性關(guān)節(jié)炎診斷中的臨床意義。方法選取正常志愿者22例(年齡20~25歲,均為女性)共22個膝關(guān)節(jié)為對照組;臨床診斷的輕度OA患者20例、中度OA患者20例、重度OA患者20例(均為女性)共60個膝關(guān)節(jié)作為病例組。采用GE 3.0T磁共振掃描儀,行膝關(guān)節(jié)T2-starmapping成像,獲得股骨內(nèi)側(cè)髁關(guān)節(jié)面、股骨外側(cè)髁關(guān)節(jié)面、脛骨內(nèi)側(cè)髁關(guān)節(jié)面、脛骨外側(cè)髁關(guān)節(jié)面、髕骨軟骨面的T2*值,比較各組T2*值的差異。獲取單髁關(guān)節(jié)置換術(shù)及全膝關(guān)節(jié)置換術(shù)后的離體軟骨標(biāo)本,經(jīng)Collins病理學(xué)分級后比較各級T2*值的差異。結(jié)果1.正常對照組關(guān)節(jié)軟骨的平均T2*值為(21.74±3.82)ms;輕度OA組關(guān)節(jié)軟骨的平均T2*值為(27.55±5.48)ms;中度OA組關(guān)節(jié)軟骨的平均T2*值為(35.01±8.83)ms;重度OA組關(guān)節(jié)軟骨的平均T2*值為(41.14±14.20)ms。2.輕度OA組、中度OA組及重度OA組關(guān)節(jié)軟骨的平均T2*值均較正常對照組關(guān)節(jié)軟骨T2*值明顯升高,差異有顯著性統(tǒng)計學(xué)意義(P0.01)。3.各OA組膝關(guān)節(jié)的五個不同部位軟骨的T2*值均較正常組升高,隨著關(guān)節(jié)軟骨退變程度加重,對應(yīng)的T2*值隨之升高,差異有統(tǒng)計學(xué)意義(P0.05)。4.軟骨退變T2*值與Collins病理分級對照,隨著軟骨退變Collins病理學(xué)分級升高,對應(yīng)的T2*值逐漸升高,T2*值隨軟骨退變程度的增高而明顯升高,各級之間均存在顯著的統(tǒng)計學(xué)差異。結(jié)論1.隨著關(guān)節(jié)軟骨退變程度加重,對應(yīng)的T2*值隨之升高。提示磁共振T2-starmapping成像軟骨定量分析可以作為診斷早期OA的檢查方法。2.軟骨退變Collins病理學(xué)分級升高,對應(yīng)的T2*值逐漸升高,T2*值隨軟骨退變程度的增高而明顯升高。關(guān)節(jié)軟骨T2*值的改變?yōu)镺A的診斷提供了一種重要的檢查方法。3.磁共振T2-star-mapping成像軟骨定量分析作為一種新的軟骨磁共振生理性成像技術(shù),通過量化分析微觀結(jié)構(gòu)的關(guān)節(jié)軟骨內(nèi)部組織成分的變化,有利于在關(guān)節(jié)軟骨發(fā)生形態(tài)學(xué)改變之前,即能在早期發(fā)現(xiàn)關(guān)節(jié)軟骨內(nèi)病變,對早期膝關(guān)節(jié)軟骨損傷的診斷和監(jiān)測具有較高的臨床應(yīng)用價值。
[Abstract]:Objective to investigate the clinical significance of quantitative analysis of cartilage with T2-star-mapping imaging in the diagnosis of knee osteoarthritis. Methods 22 normal volunteers (aged 20 to 25 years old, all female) were selected as control group, 20 patients with mild OA, 20 patients with moderate OA, 20 patients with mild OA and 20 patients with moderate OA were selected as control group. Twenty patients with severe OA (all female) had 60 knee joints as the case group. The T 2 * values of medial femoral condyle articular surface, lateral femoral condyle articular surface, medial tibial condyle articular surface, lateral tibial condyle articular surface and patellar cartilage face were obtained by GE 3.0T magnetic resonance scanner. The specimens of isolated cartilage were obtained after single condylar arthroplasty and total knee arthroplasty. The differences of T 2 * values between different levels were compared by Collins pathological grading. Result 1. The average T2 * value of articular cartilage was 21.74 鹵3.82 Ms in normal group, 27.55 鹵5.48 Ms in mild OA group, 35.01 鹵8.83 Ms in moderate OA group and 41.14 鹵14.20 ms.2ms. in severe OA group. The mean T2 * value of articular cartilage in mild OA group, moderate OA group and severe OA group was significantly higher than that in normal control group (P < 0.01). Compared with the normal group, the T2 * value of the five different parts of articular cartilage in each OA group was higher than that of the normal group. With the degeneration of articular cartilage, the corresponding T2 * value of the articular cartilage increased, and the difference was statistically significant (P 0.05. 4). Compared with the pathological grade of Collins, the T2 * value of cartilage degeneration increased gradually with the increase of Collins pathological grade of cartilage degeneration, and the T2 * value increased obviously with the increase of cartilage degeneration degree. There were significant statistical differences between different grades. Conclusion 1. With the degeneration of articular cartilage, the corresponding T 2 * value increased. The results suggest that quantitative analysis of cartilage in T2-starmapping imaging can be used as a diagnostic method for early OA. The pathological grade of degenerative cartilage Collins increased, and the corresponding T 2 * value gradually increased with the increase of cartilage degeneration degree. The change of T 2 * value of articular cartilage provides an important method for the diagnosis of OA. Quantitative analysis of cartilage with magnetic resonance imaging (T2-star-mapping), as a new technique of magnetic resonance physiologic imaging of cartilage, is beneficial to the morphological changes of articular cartilage by quantitative analysis of the internal tissue components of articular cartilage with microstructure. That is, early detection of articular cartilage lesions, early diagnosis and monitoring of knee cartilage injury has a high clinical value.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R684.3

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本文編號：1866637