中国组织工程研究 ›› 2022, Vol. 26 ›› Issue (3): 425-429.doi: 10.12307/2022.070

• 骨与关节图像与影像 bone and joint imaging • 上一篇    下一篇

MRI半定量评估早期膝骨关节炎软骨退变

张  键1,林坚平1,周  钢1,方业汉2,王本超1,吴永昌1   

  1. 海南医学院附属海南医院(海南省人民医院),1关节外科,2运动医学科,海南省海口市   570311
  • 收稿日期:2021-02-25 修回日期:2021-02-26 接受日期:2021-04-10 出版日期:2022-01-28 发布日期:2021-10-29
  • 通讯作者: 林坚平,主任医师,硕士生导师,海南医学院附属海南医院(海南省人民医院)关节外科,海南省海口市 570311
  • 作者简介:张键,男,1996年生,海南省屯昌县人,汉族,海南医学院在读硕士,医师,主要从事骨外科方面的研究。
  • 基金资助:
    海南省重点研发任务计划(ZDYF2017112),项目负责人:林坚平;海南医学院研究生创新创业项目 (HYYS2020-36),项目负责人:张键

Semi-quantitative MRI evaluation of cartilage degeneration in early knee osteoarthritis

Zhang Jian1, Lin Jianping1, Zhou Gang1, Fang Yehan2, Wang Benchao1, Wu Yongchang1   

  1. 1Department of Joint Surgery, 2Department of Sports Medicine, Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital), Haikou 570311, Hainan Province, China
  • Received:2021-02-25 Revised:2021-02-26 Accepted:2021-04-10 Online:2022-01-28 Published:2021-10-29
  • Contact: Lin Jianping, Chief physician, Master’s supervisor, Department of Joint Surgery, Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital), Haikou 570311, Hainan Province, China
  • About author:Zhang Jian, Master candidate, Physician, Department of Joint Surgery, Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital), Haikou 570311, Hainan Province, China
  • Supported by:
    Hainan Province Key Research and Development Task Plan, No. ZDYF2017112 (to LJP); Graduate Innovation and Entrepreneurship Project of Hainan Medical University, No. HYYS2020-36 (to ZJ)

摘要:

文题释义:
MRI膝关节骨关节炎评分:MRI可早期探明关节软骨退变,MRI膝关节骨关节炎评分是基于MRI检查的半定量关节软骨损伤的评估系统,其综合了波士顿利兹膝关节骨关节炎评分和全膝关节MRI成像积分的优点,并细化至各个关节分区的评估。

背景:膝骨关节炎是常见的膝关节慢性、无菌性炎症,其病理变化始于关节软骨,目前诊断该疾病主要依赖于临床表现与影像学,然而在软骨发生病理改变时,临床表现与X射线片常呈阴性结果,因此MRI成为明确关节软骨退变的重要无创性检查。
目的:探讨MRI膝骨关节炎评分系统在膝骨关节炎早期软骨退变中的应用价值。
方法:选取7只五指山小型猪建立膝骨关节炎建模,麻醉完成后,对实验侧后肢的膝前交叉韧带进行离断并剥离,对照侧后肢仅打开关节囊不对前交叉韧带做任何处理,双侧后肢均逐层缝合关节囊、皮下组织和皮肤,术后均行抗感染治疗。术后26周时,对实验侧和对照侧膝关节进行MRI检查及MRI膝骨关节炎评分,其中MRI膝骨关节炎总评分=任意缺损评分+全层缺损评分。
结果与结论:①在MRI膝骨关节炎任意软骨缺损评分对比中,实验侧与对照侧股骨外侧区、胫骨内侧区、胫骨外侧区评分相比差异有显著性意义(P < 0.05);②在MRI膝骨关节炎全层软骨缺损评分对比中,实验侧与对照侧膝关节各分区评分相比差异均有显著性意义(P < 0.05);③在关节软骨损伤MRI膝骨关节炎总评分对比中,实验侧与对照侧膝关节各分区评分相比差异均有显著性意义(P < 0.05),其中实验侧与对照侧股骨分区评分、胫骨分区评分相比差异均有显著性意义(P < 0.05);④实验侧膝关节股骨内侧区各亚分区MRI膝骨关节炎评分对比差异有显著性意义(P < 0.05),而股骨外侧、胫骨外侧、胫骨内侧各亚分区评分对比差异均无显著性意义(P > 0.05);⑤提示MRI膝骨关节炎评分系统可对膝骨关节炎早期软骨退变进行量化和分析,可细化对膝骨关节炎的阶梯治疗,值得在临床工作中推广使用。
https://orcid.org/0000-0002-7664-9741 (张键) 

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程

关键词: 骨性关节炎, MRI成像, 膝关节, 关节软骨, 关节软骨损伤, 影像学, 早期诊断, 半月板

Abstract: BACKGROUND: Knee osteoarthritis is a common chronic and aseptic inflammation of the knee joint. Its pathological changes start from the articular cartilage. The current diagnosis of this disease mainly depends on clinical manifestations and imaging. However, when the cartilage undergoes pathological changes, the clinical manifestations and X-ray films often show negative results, so MRI has become an important non-invasive examination to identify articular cartilage degeneration.  
OBJECTIVE: To explore the application value of MRI Osteoarthritis Knee Score in the early cartilage degeneration knee osteoarthritis.
METHODS:  Seven Wuzhishan miniature pigs were selected to establish knee osteoarthritis models. Every pig was narcotized, and the anterior cruciate ligament was dissected and stripped in experimental knees. Only the joint capsule of knee in control knees was opened. The joint capsule, subcutaneous tissue and skin were sutured in all knees, and anti-infection treatment was given after operation. At 26 weeks, MRI screening and MRI Osteoarthritis Knee Score were performed on the experimental and control knee joints. Total MRI Osteoarthritis Knee Score was equal to any defect score + full-thickness defect score.  
RESULTS AND CONCLUSION: (1) In the comparison of size of any cartilage loss scores, the experimental side and the control side had statistical differences in the scores of the lateral femur, medial tibia, and lateral tibia (P < 0.05). (2) In the comparison of the full-thickness cartilage loss score, the experimental side and the control side had statistical differences in the scores of each region of the knee joint (P < 0.05). (3) In the comparison of the total scores of articular cartilage injury, the scores of the knee joints of the experimental side and the control side were statistically different (P < 0.05). The scores of femoral region and tibial region were statistically different between the experimental side and the control side (P < 0.05). (4) There was a statistically significant difference in the sub-division scores of the medial femoral area on the experimental side of the knee joint (P < 0.05), and there was no statistical difference in the scores of the other sub-divisions of lateral femur, lateral tibia, medial tibia (P > 0.05). (5) It is indicated that the MRI Osteoarthritis Knee Score system can quantify and analyze knee osteoarthritis cartilage degeneration, and refine the ladder treatment of knee osteoarthritis. It is worth promoting and using in clinical work.

Key words: osteoarthritis, magnetic resonance imaging, knee, cartilage, articular cartilage injury, radiography, early diagnosis, meniscus

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