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1.
目的 评价三维扰相脂肪抑制梯度回波序列(3 D-WATSc)在膝关节软骨缺损性病变中的诊断价值.方法 41例患者50侧膝关节镜检查病例,将每侧膝关节软骨面分为5个区域,MRI检查采用3D-WATSc,按Recht标准分级诊断250个关节软骨面,并与膝关节镜分级诊断结果对照.3D-WATSc诊断价值的真实性指标为敏感度、特异度、准确度,一致性指标用Kappa值.结果 3D-WATSc诊断软骨病损的敏感度为96.4%,特异度为87.3%,准确度为92.4%,Kappa值为0.844.结论 3D-WATSc与关节镜对膝关节软骨病损的诊断结果之间一致性极佳,是目前诊断膝关节软骨病损的最佳扫描序列.  相似文献   

2.
目的 分析评价3.0T磁共振3D-FS-SPGR序列对膝关节软骨损伤的诊断价值.方法 对将要进行关节镜检查的35个膝关节进行磁共振多序列、多方位成像,其中包括矢状位3D-FS-SPGR序列及矢状位、冠状位、轴位FS-FSE-T2WI序列.在MRI上对股骨内外侧髁、胫骨内外侧平台、股骨滑车及髌骨6个关节面关节软骨(共210处)进行评价.将3D-FS-SPGR序列及FS-FSE-T2WI序列上软骨损伤分级与关节镜分级进行比较.结果 3D-FS-SPGR序列对软骨损伤显示的敏感度为97.50%,特异度为97.69%,Kappa值为0.798 ;FS-FSE-T2WI序列的敏感度 为90.00%,特异度为94.61%,Kappa值为0.714.结论 3D-FS-SPGR序列显示膝关节软骨损伤优于FS-FSE-T2WI序列;3D-FS-SPGR序列是目前诊断膝关节软骨损伤的最佳序列之一.  相似文献   

3.
目的 比较抑脂三维梯度回波序列FS -3D -FSPGR和抑脂快速自旋回波T2 WIMR成像序列FS -FSE -PD T2 WI诊断软骨病变的准确性。方法  2 3例临床病例 ,采用抑脂三维梯度回波序列和抑脂快速自旋回波T2 WIMR成像序列扫描 ,前瞻性分级诊断 184个关节软骨面 ,分别与关节镜分级结果对照。采用双盲法计算出各序列用于诊断软骨缺损的敏感度、特异度和准确度、Kappa值。结果 FS -3D -FSPGR序列诊断软骨损伤的敏感度为 86% ,特异度为 96% ,Kappa值为 0 .80 ;FS -FSE -PD T2 WI序列诊断的敏感度为 46% ,特异度为 99% ,Kappa值为 0 .5 6。结论 附加脂肪抑制的三维梯度回波序列诊断膝关节透明病变的敏感度、准确性高于附加脂肪抑制的快速自旋回波T2 WI,仍为目前诊断软骨病变的最佳扫描序列  相似文献   

4.
目的探讨光纤1.5T磁共振在膝关节急性软骨损伤时的序列优化,及其在不同级别损伤中的诊断价值。方法收集40例急性膝关节外伤患者,行常规扫描并加扫FS-3D-SPRG(fast)、Fiesta-c、MERGE序列,患者两周内进行临床手术或关节镜治疗,将临床手术或关节镜结果作为金标准,评价上述序列在不同级别软骨损伤时的准确度、敏感度、特异度和临床一致性(Kappa值)。结果 1)FS-3D-SPRG(fast)序列的敏感度为94.29%,特异度为95.29%,Kappa值为0.793;2)Fiesta-c序列的敏感度为92.21%,特异度为98.16%,Kappa值为0.896;3)MERGE序列的敏感度为90.54%,特异度为95.18%,Kappa值为0.558。结论 1)Fiesta-c序列具有良好的软骨/关节液、软骨/骨对比度,与临床手术的符合度很高,尤其对软骨钙化带的显示最为清晰;2)3D-FS-SPGR(fast)序列经过参数改动,扫描时间明显缩短(仅需3min11s),在本次实验中也得到了较好的效果,可作为软骨损伤时的优化序列,但低级别软骨损伤时假阴性较高;3)采用3D-FS-SPGR序列进行MIP重建,可得到直观软骨图像,对诊断有较大参考意义;4)MERGE序列在本次研究中,无论从软骨显示,还是与临床结果对照,不及PDWI、Fiesta-c、3D-FS-SPGR序列。  相似文献   

5.
目的:评价SE序列T1WI、SE序列T1WI并加FS和MTC技术以及GRE序列T2*WI三种MR扫描序列在间接法关节造影中诊断膝关节半月板及韧带损伤的价值。方法:分别应用间接法MR膝关节造影三种序列对51例膝关节损伤患者进行检查,并与关节镜手术临床诊断结果比较。结果:①在诊断前交叉韧带损伤上,T2WI序列的敏感度为60%、特异度为100%、Kappa值为0.605;加FS和MTC技术T1WI序列的敏感度为81.82%、特异度为100%、Kappa值为0.825;GRE序列的敏感度为36%、特异度为100%、Kappa值为0.313;②在诊断后交叉韧带损伤上,T2WI序列的敏感度为100%、特异度为100%、Kappa值为0.827;加FS和MTC技术T1WI序列的敏感度为100%、特异度为100%、Kappa值为0.827;GRE序列的敏感度为75%、特异度为100%、Kappa值为0.759;③在诊断半月板损伤上,T1WI序列的敏感度为95.56%、特异度为98.85%、Kappa值为0.926;加FS和MTC技术T2WI序列的敏感度为95.65%、特异度为99.23%、Kappa值为0.951;GRE序列的敏感度为93.75%、特异度为99.61%、Kappa值为0.928;④在诊断侧副韧带损伤上,T1WI序列的敏感度为77.27%、特异度为98.75%、Kappa值为0.823;加FS和MTC技术T1WI序列的敏感度为90%、特异度为100%、Kappa值为0.938;GRE序列的敏感度为73.91%、特异度为98.73%、Kappa值为0.712。结论:T1WI加FS及MTC技术序列是诊断膝关节损伤病变,尤其是前交叉韧带损伤的最佳序列。  相似文献   

6.
磁共振敏感序列与关节镜在膝关节软骨病变中的对比研究   总被引:1,自引:1,他引:0  
目的评价软骨敏感序列脂肪抑制梯度回波序列(FS-GRE)、脂肪抑制快速自旋回波序列(FS-FSE)及三维脂肪抑制扰相梯度回波序列(3D-FS-SPGR)诊断膝关节软骨病变的价值。资料与方法对36例经临床证实为骨性关节炎的患者行MRI常规、FS-GRE、FS-FSE及3D-FS-SPGR序列扫描,通过三种序列对膝关节软骨病变的显示并与关节镜对照,分析三种序列诊断软骨病变的可行性。结果 36例患者三种序列诊断膝关节软骨病变的结果与关节镜一致,3D-FS-SPGR序列的敏感性为99.2%,特异性为94.4%;FS-GRE序列的敏感性为98.8%,特异性为86.1%;FS-FSE序列的敏感性为97.2%,特异性为83.3%,Kappa均>0.75,其中FS-FSE序列与关节镜的一致性相对较差(Kappa=0.796);3D-FS-SPGR序列诊断膝关节软骨病变与关节镜的一致性最好(Kappa=0.937)。结论 3D-FS-SPGR序列诊断膝关节软骨病变与关节镜有较高的一致性,可以作为膝关节软骨病变的常规扫描序列。  相似文献   

7.
目的:以关节镜检查结果为标准,分析评价3.0T磁共振3D-FS-SPGR序列对膝关节软骨损伤的诊断价值。方法:对将要进行关节镜检查的50个膝关节进行磁共振多序列、多方位成像,包括矢状位FSE-T2WI、FSE-T1WI、FS-FSE-T2WI、3D-FS-SPGR序列及冠状位、轴位FS-FSE-T2WI序列。利用矢状位3D-FS-SPGR序列图像重建出冠状位及轴位图像。将磁共振检查结果与随后进行的关节镜检查结果进行对照。在MRI上对股骨内外侧髁、胫骨内外侧平台、股骨滑车及髌骨六个关节面关节软骨(共300处)进行评价。另外选取10名志愿者20个膝关节作为对照组进行MR成像,成像序列同患者组。结果:①在FS-FSE-T2WI序列上正常膝关节软骨为光滑的曲线状高信号带,在股骨内、外髁及胫骨平台表面关节软骨呈由表及里的高、低、高3层结构;FSE-T2WI及FSE-T1WI上关节软骨分层现象不明显呈中低信号;在3D-FS-SPGR序列上关节软骨呈明显带状高信号并呈由表及里的高、低、高3层结构;②软骨I级损伤在FS-FSE-T2WI上表现为低或高信号,在3D-FS-SPGR序列上表现为低信号,软骨分层现象消失;软骨缺损(II~IV级损伤)在FSE-T1WI上呈等信号,在FSE-T2WI及FS-FSE-T2WI上表现为高信号,在3D-FS-SPGR上表现为低信号;③3D-FS-SPGR序列对软骨损伤显示的敏感度为91.4%,特异度为95.9%,Kappa值为0.808(〉0.75);FS-FSE-T2WI序列的敏感度为88.9%,特异度为96.8%,Kappa值为0.774(〉0.75);FSE-T2WI序列的敏感度为75.3%,特异度为98.2%,Kappa值为0.548;FSE-T1WI序列的敏感度为64.2%,特异度为99.1%,Kappa值为0.444。结论:①FSE-T2WI、FSE-T1WI、FS-FSE-T2WI、3D-FS-SPGR序列均可以很好的显示膝关节软骨,以3D-FS-SPGR序列显示的最清晰;②3D-FS-SPGR序列显示膝关节软骨损伤优于FSE-T2WI、FSE-T1WI、FS-FSE-T2WI序列,为诊断膝关节软骨损伤的最佳序列。  相似文献   

8.
膝关节关节软骨损伤的MRI评价   总被引:7,自引:1,他引:6  
目的:以关节镜为标准,评价不同MR成像序列(T2WI、T1WI及FS T2WI)对膝关节软骨损伤的诊断价值.方法:回顾性分析经关节镜证实的60例(60个)膝关节的MRI资料,MRI包括矢状位T2WI、T1WI及FS T2WI,冠状位FS T2WI,部分病人还行轴位FS T2WI.MRI图像对股骨内外髁、胫骨内外平台、股骨滑车及髌骨六个关节面关节软骨(共360处)进行评价,并与关节镜图像逐一对照.结果:①在FS T2WI上正常膝关节软骨为光滑的曲线状高信号带,在股骨内、外髁及胫骨平台表面关节软骨呈由表及里的高、低、高3层结构;T2WI及T1WI上关节软骨分层现象不明显呈中低信号;②与关节镜对照,60个膝关节软骨损伤患者的MRI检查结果:FS T2WI的敏感度为90.2%,特异度为96.6%,Kappa值为0.766;T2WI的敏感度为80.5%,特异度为98.5%,Kappa值为0.537;T1WI的敏感度为63.0%,特异度为99.3%,Kappa值为0.367.结论:FS T2WI序列显示膝关节软骨损伤的准确性优于T2WI和T1WI序列并与关节镜诊断结果之间具有良好的一致性.T2WI、T1WI及FS T2WI三序列在诊断膝关节软骨损伤的准确性方面有显著差性异.  相似文献   

9.
目的探讨分析不同MRI序列对膝关节软骨损伤诊断敏感度及特异度。方法选择我院收治的膝关节软骨损伤患者75例,对患者分别进行MRI常规序列以及T_2-mapping序列检查,关节镜检查结果作为金标准,分析不同MRI检查序列对膝关节软骨损伤诊断情况。结果 275例患者共375个关节软骨行常规MRI序列扫描以及关节镜诊断,常规RMI序列与关节镜分级一致性为0.638,表明MRI常规扫描与关节镜分级之间具有一定的一致性。T_2-mapping序列与关节镜分级一致性为0.816,表明MRI常规扫描与关节镜分级之间具有良好的一致性。MRI常规扫描诊断灵敏度为59.85%,诊断特异度为96.71%,T_2-mapping序列扫描诊断灵敏度为75.00%,诊断特异度为98.77%,T_2-mapping序列扫描诊断灵敏度显著高于MRI常规扫描(P0.05),T_2-mapping序列扫描与MRI常规扫描特异度无明显差异(P0.05)。结论 T_2-mapping序列扫描对膝关节软骨损伤诊断分级更为准确,且诊断敏感度较常规MRI更高。  相似文献   

10.
目的 使用脂肪抑制三维稳态进动快速成像(FS-3D-FISP)序列动态观察兔骨性关节炎动物模型,探讨FS-3D-FISP序列对关节软骨损伤的诊断价值.方法 选用雄性新西兰大白兔18只,制作骨性关节炎模型,左膝关节腔注射木瓜蛋白酶0.5 ml,右膝关节腔注射等量无菌生理盐水作为对照.建模后第1、2、4周行膝关节核磁共振检查,扫描序列采用FS-3D-FISP序列,并取双侧股骨髁部和胫骨平台,观察骨关节大体形态和病理改变.按Outerbridge分级法对软骨病变进行MR图像以及大体标本观察,病理评价使用Collins分级.结果 FS-3D-FISP序列成像与大体标本及病理结果相对照,MR分级与大体标本分级之间具有较好的一致性(Kappa值0.806,P值<0.001);MRI软骨病损Ⅰ~Ⅱ级为1组,Ⅲ~Ⅳ级为另1组,与病理I~II级,III~IV级分组进行相关对照分析,2组间(Kappa值0.827,P<0.001)分级一致性较高.结论 FS-3D-FISP能准确评价软骨损伤的程度.  相似文献   

11.
目的:比较三维双回波稳态(3D-DESS)序列30°与90°反转角对2级及以上膝关节软骨损伤程度的诊断准确性。方法利用1.5T MR 3D-DESS 序列分别采用30°及90°反转角成像获得13例膝关节软骨损伤患者(男2例,女11例,年龄18~68岁)的MR 图像。由2名放射科医生阅片判断:软骨损伤≥2级为阳性(P),<2级为阴性(N)。以关节镜作为金标准,并与随后行关节镜检查诊断的一致率进行比较。评估软骨损伤诊断得分分3类:3分,肯定诊断;2分,可能诊断;1分,不能做出诊断。结果通过3D-DESS 图像和关节镜检查结果作一致性比较,6个膝关节面90°反转角一致率显著较高(Kappa 值=1.000,0.843,1.000,0.806,0.967,0.909;P <0.001,P <0.004,P <0.004,P <0.002,P <0.001,P <0.001),90°反转角的图像比30°反转角的图像更好地显示所有软骨面。结论3D-DESS 序列评价膝关节软骨表面损伤,90°反转角比30°的常规设置更有效。  相似文献   

12.
目的:比较质子加权预饱和脂肪抑制序列(PDW-FS)和自旋回波T2WI对诊断膝关节软骨损伤的准确性,探讨PDW-FS对软骨损伤的诊断价值。方法:对关节镜探查手术的37例45只膝关节,术前行MR检查,作回顾性分析,比较PDW-FS、T2WI序列诊断软骨损伤的价值。结果:以关节镜为标准,PDW-FS和T2WI序列的Kappa值分别为0.88和0.68,PDW-SF检查结果与关节镜结果一致性好。PDW-FS敏感度89.7%,特异度97.1%,T2WI敏感度79.1%,特异度94.8%,差异有统计学意义(χ2=4.50,P〈0.05)。结论:PDW-FS序列诊断膝关节软骨损伤的准确性优于T2WI,可准确地判断软骨损伤的范围和深度,为临床医生选择合适的治疗方案提供可靠依据。  相似文献   

13.

Purpose

We sought to retrospectively compare the accuracy of a three-dimensional fat-suppressed, fast spin-echo sequences acquired in the sagittal plane, with multiplanar reconstructions to that of two-dimensional fat-suppressed, fast spin echo sequences acquired in three planes on a 3 T MR system for the evaluation of articular cartilage in the knee.

Materials and methods

Our study group consisted of all patients (N = 34) that underwent 3 T MR imaging of the knee at our institution with subsequent arthroscopy over an 18-month period. There were 21 males and 13 females with an average age of 36 years. MR images were reviewed by 3 musculoskeletal radiologists, blinded to operative results. 3D and 2D sequences were reviewed at different sittings separated by 4 weeks to prevent bias. Six cartilage surfaces were evaluated both with MR imaging and arthroscopically with a modified Noyes scoring system and arthroscopic results were used as the gold standard. Sensitivity, specificity, and accuracy were calculated for each reader along with Fleiss Kappa assessment agreement between the readers. Accuracies for each articular surface were compared using a difference in proportions test with a 95% confidence interval and statistical significance was calculated using a Fisher's Exact Test.

Results

Two hundred and four articular surfaces were evaluated and 49 articular cartilage lesions were present at arthroscopy. For the patellofemoral surfaces, the sensitivity, specificity, and accuracy were 76.5%, 83%, and 78.2% for the 3D sequences and were 82.3%, 76%, and 82% respectively for the 2D sequences. For the medial compartment surfaces, the sensitivity, specificity, and accuracy were 81.1%, 65.1%, and 78.5% for the 3D sequences and were 82.5%, 48%, and 76.7% respectively for the 2D sequences. For the lateral compartment surfaces, the sensitivity, specificity, and accuracy were 89.3%, 39%, and 79.5% for the 3D sequences and were 94.7%, 18.8%, and 79.5% respectively for the 2D sequences. The accuracies were not significantly different between 3D and 2D sequences. Fleiss Kappa agreement values for the assessment of inter-observer agreement ranged from substantial for the patella and medial femur to moderate for the trochlea and fair for the medial tibia and lateral compartment.

Conclusion

There was no significant difference in accuracy for the evaluation of articular cartilage of a single three-dimensional, fast spin echo sequence with multi-planar reformatted images vs. two-dimensional, fast spin echo sequences acquired in all three imaging planes in the knee.  相似文献   

14.
Objective. To determine the accuracy of T2*-weighted three-dimensional (3D) gradient-echo articular cartilage imaging in the identification of grades 3 and 4 chondromalacia of the knee. Design and patients. A retrospective evaluation of 80 patients who underwent both arthroscopic and MRI evaluation was performed. The 3D images were interpreted by one observer without knowledge of the surgical results. The medial and lateral femoral condyles, the medial and lateral tibial plateau, the patellar cartilage and trochlear groove were evaluated. MR cartilage images were considered positive if focal reduction of cartilage thickness was present (grade 3 chondromalacia) or if complete loss of cartilage was present (grade 4 chondromalacia). Comparison of the 3D MR results with the arthroscopic findings was performed. Results. Eighty patients were included in the study group. A total of 480 articular cartilage sites were evaluated with MRI and arthroscopy. Results of MR identification of grades 3 and 4 chondromalacia, all sites combined, were: sensitivity 83%, specificity 97%, false negative rate 17%, false positive rate 3%, positive predictive value 87%, negative predictive value 95%, overall accuracy 93%. Conclusion. The results demonstrate that T2*-weighted 3D gradient-echo articular cartilage imaging can identify grades 3 and 4 chondromalacia of the knee. Received: 18 April 2000 Revision requested: 18 July 2000 Revision received: 10 October 2000 Accepted: 27 November 2000  相似文献   

15.
MRI对急性膝关节软骨损伤的评价   总被引:16,自引:1,他引:15  
目的 分析急性膝关节软骨损伤的MRI表现,以达到准确评价关节软骨损伤的范围及程度。方法 分析34例在15d内有膝关节损伤病史,且经关节镜和手术证实为关节软骨损伤患者的膝关节MRI所见,着重观察关节软骨和软骨下骨的改变,并与关节镜和手术结果对照分析。结果 34例急性损伤膝关节中有29例在MRI上表现异常,其中软骨信号异常改变4例,软骨局限性变薄3例,骨软骨压迹3例,软骨凹凸不平(皱褶)3例,软骨连续性中断13例,软骨缺损2例,软骨缺损伴关节内游离软骨体1例。MRI还发现关节镜无法观察到的骨挫伤、隐匿性骨折等改变。结论 MRI对急性关节软骨损伤的显示准确,MRI结合关节镜检查可准确评价急性膝关节损伤的范围、程度,可决定治疗方案.  相似文献   

16.
Twenty-one MRI studies with a fat-suppression three-dimensional spoiled gradient-recalled echo in a steady state (3D SPGR) pulse sequence after intravenous contrast injection were evaluated to assess the accuracy in depicting chondromalacia of the knee. On the basis of MR images, chondromalacia and its grade were determined in each of five articular cartilage regions (total, 105 regions) and then the results were compared to arthroscopic findings. The sensitivity, specificity, and accuracy of MRI were 70%, 99%, and 93%, respectively. MR images depicted 7 of 11 lesions of arthroscopic grade 1 or 2 chondromalacia, and seven of nine lesions of arthroscopic grade 3 or 4 chondromalacia. The cartilage abnormalities in all cases appeared as focal lesions with high signal intensity. Intravenous contrast-injection, fat-suppression 3D SPGR imaging showed high specificity in excluding cartilage abnormalities and may be considered as an alternative to intra-articular MR arthrography when chondromalacia is suspected.  相似文献   

17.
目的比较分析高频超声与磁共振(MRI)对急性外伤性髌骨外侧脱位的诊断价值。方法对33例临床证实急性外伤性髌骨外侧脱位的高频超声和MRI资料,以手术结果为金标准,计算高频超声、MRI诊断各种伴随伤的敏感性、特异性和准确性,比较两种检查方法的有效性。结果与手术结果比较,高频超声、MRI诊断MPFL部分撕裂的敏感性、特异性、准确性分别为85.7%、85.7%,94.7%、89.5%,90.9%、87.9%;诊断MPFL完全撕裂的敏感性、特异性、准确性分别为94.7%、89.5%,85.7%、85.7%,90.9%、87.9%。高频超声、MRI诊断关节软骨Ⅱ级损伤的敏感性、特异性、准确性分别为36.4%、81.8%,85%、100%,67.7%、93.5%。高频超声、MRI诊断关节软骨Ⅲ级损伤的敏感性、特异性、准确性分别为81.8%、90.9%,85%、90%,83.9%、90.3%;高频超声、MRI诊断关节软骨Ⅳ级损伤的敏感性、特异性、准确性分别为100%、100%,90.9%、95.5%,93.5%、96.8%。高频超声对MPFL撕裂、关节软骨损伤的诊断与MRI比较差异无统计学意义(P>0.05)。结论高频超声检查与MRI检查同样能对急性外伤性髌骨外侧脱位的各种伴随损伤明确诊断和准确分级,是一种简单可靠、快捷并可重复的诊断方法,可作为急性外伤性髌骨外侧脱位的常规检查方法。  相似文献   

18.
半月板损伤的MRI诊断与关节镜对照研究   总被引:2,自引:0,他引:2  
目的:评价MRI对半月板损伤的诊断价值,为临床诊断和治疗半月板损伤提供可靠的影像学依据。方法:对138例拟行关节镜术的膝关节疼痛患者进行术前MRI检查,并于MRI检查后2周内行关节镜术。结果:符合纳入标准的84例患者中,与关节镜结果对照,MRI诊断半月板Ⅰ级损伤、Ⅱ级损伤的符合率分别为100%和91.1%;诊断半月板撕裂的敏感度、特异度、符合率、Kappa值分别为91.5%、90.7%、91.1%和0.82;对半月板撕裂类型诊断的敏感度、特异度、符合率和Kappa值分别为90.9%、85.7%、88.1%和0.76。结论:与关节镜比较,MRI显示半月板Ⅰ、Ⅱ级损伤时的内部信号改变更敏感。MRI诊断半月板撕裂,与关节镜结果具有极好的一致性,并能准确评价半月板撕裂类型。MRI检查可作为评价半月板损伤的首选方法,对半月板损伤临床治疗方案的选择具有重要指导意义。  相似文献   

19.
Recent advances in MRI have enabled the quantitative assessment of articular cartilage morphology in human joints. In this study, we tested the hypothesis that the precision of quantitative shoulder cartilage measurements is sufficient to detect changes between and within patients, and that shoulder cartilage thickness in paraplegic patients increases due to increased loading. We imaged the shoulders of seven healthy volunteers four times using a coronal 3D, fat-suppressed, gradient-echo sequence. The humeral head cartilage in seven paraplegic patients was evaluated soon after injury and 1 year post injury. A precision of 4.5% (root mean square (RMS) average coefficient of variation (CV) %) was found for shoulder cartilage thickness measurements in the humeral head. Whereas a significant decrease of cartilage thickness (-11%, P < 0.05) was observed in the knee, there was no significant change in articular cartilage thickness in the shoulder (-1.1%). Our data show, for the first time, that articular cartilage of the humeral head can be quantified with acceptable precision in vivo. It was demonstrated that, in contrast to the knee, the articular cartilage morphology of the humeral head changes very little (i.e., there is no significant increase or decrease in thickness) after spinal cord injury (SCI).  相似文献   

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