软骨延迟增强磁共振成像诊断早期髌骨软化症

目的：探讨dGEM RIC用于诊断早期髌骨软化症的可行性和价值。方法选取41例早期髌骨软化症患者，先行3D-FS-SPGR系列平扫检查，经肘静脉注射钆喷酸葡胺后步行10min 使对比剂尽量弥散至髌关节软骨内，注射后2h再行3D-FS-SPGR延迟增强对关节软骨进行评价，并将检查结果与关节镜检查结果进行对照。结果3D-FS-SPGR系列上正常髌软骨呈明显带状高信号，并可见高-低-高三层结构；软骨损伤在3D-FS-SPGR上呈相对稍低信号，在dGEM RIC系列上呈局灶高信号；3D-FS-SPGR序列平扫对Ⅰ期髌软骨损伤显示的符合率为36.8％（7/19），对Ⅱ期髌骨软化病变符合率为50％（11/22），延迟增强扫描对Ⅰ期髌骨软化病变符合率为73.7％（14/19），对Ⅱ期髌骨软化病变符合率为86.4％（19/22）。经t检验，髌软骨Ⅰ、Ⅱ期损伤的延迟增强扫描诊断符合率均明显高于平扫(Ⅰ期t=2.646，P=0.016；Ⅱ期t=2.531，P=0.017)。结论3D-FS-SPGR延迟增强扫描判断髌软骨早期损伤比平扫更敏感,是一种诊断早期髌骨软化症的有优势的、无创的方法。

Valu of dGEMRIC in Diagnosing Early Chondromal Acia patellae

Objective Todiscuss the feasibility and the value of dGEMRIC in diagnosis of ea rly stage of chondromal acia patellae. Methods 41 patients with Chondromalacia patellae patients at early stage.3D-FS-SPGR series horizontal scan, the patients were asked to walk for 10min to make the medium disperse into the cartilage. The patients underwent dGEMRIC scan 2h later. The results compared with Arthroscopy results.Results Normal patellar articular cartilage was evident on the series band and visible high-and low-high signal three-storey structure in 3D-FS-SPGR series. Cartilage damage are relatively low signal in 3D-FS-SPGR. Are focal in dGEM RIC series high signal. 3D-FS-SPGR scan of patellar cartilage stageⅠ showed the rate 36.8% (7/19), stageⅡ of Chondromalacia disease rate 50% (11/22), delayed enhanced stageⅠof Chondromalacia disease rate 73.7% (14/19), stageⅡof Chondromalacia disease rate 86.4% (19/22). The t test, patellar cartilage delayed enhancement scan in diagnosis of stageⅠandⅡ injury rate were significantly higher than the plain( StageⅠ t=2.646, P=0.016, StageⅡ t=2.531, P=0.017).Conclusion 3D-FS-SPGR delay-enhanced judgement patellar cartilage injury more sensitive than flat whisk, is an early diagnosis of Chondromalacia patellae has advantages, non-invasive method.