关节软骨的MRI研究现状

关节疾病是常见的慢性疾病之一，严重影响人们的生活质量和健康，因此越来越受到人们的关注。部分关节疾病最早侵犯关节软骨，引起软骨退变和破坏，早期的软骨退变可以通过药物等非手术方法延缓病情甚至可以治愈，而晚期病变则治疗效果不佳，因此选择一种能够准确诊断软骨早期病变并无创伤性的方法显得尤为重要。常规X线和CT检查     

膝关节关节软骨损伤的MRI研究

膝关节是人体最复杂的关节,膝关节损伤居所有关节损伤之首。在膝关节病变的影像诊断中,X线摄片仅显示骨性结构的改变,软骨等结构的显示还须依靠其他影像技术,尤其是MRI能确定软骨损伤的性质及范围,已成为重要的检查手段之一。本文就膝关节关节软骨的MRI诊断及研究进展进行概述。1膝关节关节软骨断层影像解剖膝关节内,各关节骨表面被覆关节软骨。MR扫描显示髌股关节表面平整光滑,但关节腔形态不尽相同,分别呈磨合紧密狭窄凸向后的弧形、前后径短的横位“X”形及前小后大相通的“工”字形[1]。郭世萍等[2]用一组男尸标本,依据解剖学骨性标…     

应用MRI技术提高关节软骨疾病的诊断水平

在MRI出现之前，关节软骨的非侵入性直接成像是不可能的，关节软骨几乎是影像检查的盲点。20世纪80年代后期随着MR的出现及广泛应用，其对关节软骨的显示能力逐渐被人们所认识，并应用于临床，成为目前非侵入性评价关节软骨的主要影像学方法。如今MRI对关节软骨的评价已经从最初的形态学评价发展为功能评价，以及形态一功能关系的评价，而且正进一步向分子水平迈进。     

关节软骨MRI研究：不同序列之间的比较

关节软骨是覆盖在关节表面的薄层透明软骨，传统评价关节软骨的主要方法是关节造影和关节镜，两者均为有创检查，现已逐步被MRI取代，MRI的临床应用使对关节软骨的研究进一步深入，近年来，越来越多的作者使用和开发各种不同的MRI序列来研究正常和病理的关节软骨，到底何种MRI序列是评价关节软骨的最好方法，学术上仍存在争议，对不同MRI序列应用于关节软骨的研究现状进行综述和比较。     

关节软骨的MRI研究

ＭＲＩ是目前唯一无创伤性又能清楚显示关节软骨的检查方法，但ＭＲＩ评价关节软骨的 切作用至今沿无定论。本对正常及异常软骨的ＭＲＩ表现，检查关节软骨病变的各种脉冲序列以及关节软骨ＭＲＩ的发展方向作了简要综述。     

膝关节软骨退行性损害的MRI诊断

膝关节是人体最大的承重关节之一，发生退行性骨关节病的概率很高，作为退行性骨关节病的首发病变，MRI对关节软骨病变的诊断有独特的优势，笔者对60例72个慢性损伤膝关节患者进行了MRI检查，分析了软骨关节面损伤的MRI征象，以探讨MRI诊断膝关节软骨退行性损害的能力。     

关节透明软骨的MRI实验研究

关节透明软骨的ＭＲＩ实验研究吴春江蒋学祥李松年刘赓年笔者对３０个新鲜离体牛髌骨及１０名健康志愿者的髌软骨进行系列的ＭＲＩ研究和相应的组织学对照研究，旨在认识正常关节软骨的ＭＲＩ信号特点。一、材料和方法１．材料：２岁龄牛髌骨３０个，１８～３０岁健康志愿...     

关节软骨MRI的进展

关节软骨在维持关节承重及正常活动中起重要作用。软骨病变是影响关节稳定的重要因素。MRI具有良好的信噪比及软组织分辨力,为诊断关节软骨病变提供了独特的检测方法,随着多种磁共振技术的开发应用,逐渐在关节病变中显示出其独特优势。     

Quantitative MRI of articular cartilage and its clinical applications

Cartilage is one of the most essential tissues for healthy joint function and is compromised in degenerative and traumatic joint diseases. There have been tremendous advances during the past decade using quantitative MRI techniques as a noninvasive tool for evaluating cartilage, with a focus on assessing cartilage degeneration during osteoarthritis (OA). In this review, after a brief overview of cartilage composition and degeneration, we discuss techniques that grade and quantify morphologic changes as well as the techniques that quantify changes in the extracellular matrix. The basic principles, in vivo applications, advantages, and challenges for each technique are discussed. Recent studies using the OA Initiative (OAI) data are also summarized. Quantitative MRI provides noninvasive measures of cartilage degeneration at the earliest stages of joint degeneration, which is essential for efforts toward prevention and early intervention in OA. J. Magn. Reson. Imaging 2013;38:991–1008. © 2013 Wiley Periodicals, Inc.     

开展脊神经成像的临床应用

影像医学对临床医学和基础医学的研究和发展起着十分重要的作用，近几年来，影像医学技术的开发和应用愈来愈引起人们的普遍重视。现代医学对影像学的要求越来越高，追求的目标是全面、快速、准确和无创性地给临床提供有价值的诊断信息,本期有关脊神经成像的数篇论文及以往《中华放射学杂志》所发表的有关这方面的论文，反映了我国放射学同仁应用CT、MR新技术开展周围神经成像的研究进展。     

Non-invasive MRI assessment of the articular cartilage in clinical studies and experimental settings

Attrition and eventual loss of articular cartilage are important elements in the pathophysiology of osteoarthritis (OA). Preventing the breakdown of cartilage is believed to be critical to preserve the functional integrity of a joint. Chondral injuries are also common in the knee joint, and many patients benefit from cartilage repair. Magnetic resonance imaging (MRI) and advanced digital post-processing techniques have opened possibilities for in vivo analysis of cartilage morphology, structure, and function in healthy and diseased knee joints. Techniques of semi-quantitative scoring of human knee cartilage pathology and quantitative assessment of human cartilage have been developed. Cartilage thickness and volume have been quantified in humans as well as in small animals. MRI detected cartilage loss has been shown to be more sensitive than radiographs detecting joint space narrowing. It is possible to longitudinally study knee cartilage morphology with enough accuracy to follow the disease-caused changes and also evaluate the therapeutic effects of chondro-protective drugs. There are also several MRI methods that may allow evaluation of the glycosaminoglycan matrix or collagen network of articular cartilage, and may be more sensitive for the detection of early changes. The clinical relevance of these methods is being validated. With the development of new therapies for OA and cartilage injury, MR images will play an important role in the diagnosis, staging, and evaluation of the effectiveness of these therapies.     

关节软骨MR影像表现特点和各种影响因素

目的探讨关节软骨的ＭＲＩ表现特点以及各种因素对软骨层次、厚度和信号强度的影响。方法取１２只新鲜人膝关节标本,行各种位置和序列的ＭＲ成像。标本脱钙、切片、染色后用偏光显微镜观察。结果ＭＲＩ上关节软骨的厚度、层次和信号强度与软骨内纤维排列方向、软骨基质的含量、各区域宽度、容积效应、化学位移、各向异性和成像序列密切相关。结论ＭＲＩ检查判断关节软骨结构需兼顾年龄和其他诸多技术因素     

骨髓间充质干细胞修复关节软骨损伤的MRI示踪研究进展

骨髓间充质干细胞能促进骨关节损伤的修复,使用磁共振成像(MRI)对移植入人体的细胞分布状况进行活体示踪具有重要的临床意义,也是目前分子影像学研究的热点之一.MRI示踪需要对干细胞进行标记,目前方法较多,标记物主要有钆、超顺磁性氧化铁以及报告基因成像.本文就骨髓间充质干细胞BMSCs对修复软骨缺损的作用及BMSCs在磁共振分子成像中的研究进展综述如下.     

Frontiers in musculoskeletal MRI: articular cartilage

The techniques and uses of MRI in current clinical practice, primarily as a means to detect morphologic abnormalities, are reviewed. Ongoing development of techniques that can improve morphologic assessment including techniques to increase spatial and contrast resolution is discussed, as are methods to measure cartilage volumes and thickness. Finally, several of the more widely studied techniques used to probe loss of the macromolecular structure of cartilage prior to the development of macroscopic defects are presented and compared.     

开展运动相关损伤的影像学研究

随着2008年北京奥林匹克运动会日益临近,我国掀起了全民健身高潮,运动医学的发展也越来越为广大医学工作者所重视.从1928年国际运动医学联合会(FIMS)成立到1978年中国运动医学会成立,再到2008年的奥运年,运动医学的发展非常迅速,涵盖的内容和服务的对象越来越广.     

膝关节关节软骨损伤的MRI评价

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.     

Sodium MRI of human articular cartilage in vivo

Preliminary results from in vivo sodium MRI of human patellar articular cartilage are presented. Sodium images generated of an in vitro bovine patella clearly distinguish the region of proteoglycan depletion from the region of healthy cartilage. This provides the first evidence that sodium imaging may be used to detect changes due to osteoarthritis in vivo. The process of optimizing imaging time and signal-to-noise ratio, as well as potential implications in the detection of osteoar-thritic change, are discussed.     

MRI对急性膝关节软骨损伤的评价

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.