动态增强MRI在骨关节中的热点研究

文题释义：动态增强MRI：是一种MRI功能成像技术，采用快速MRI序列连续采集静脉注射对比剂前、中、后的图像，显示对比剂进入靶器官或组织血管、通过毛细血管床并最终被清除过程中的信息。与常规核磁增强不同的是，动态增强能够提供每一个时间点的强化信息，目前在肿瘤病灶的检出、良恶性病变的鉴别、肿瘤分级、肿瘤放化疗疗效监测、治疗后的预后评价等方面有重要的价值。偶极-偶极作用：极性分子因电荷分布不均产生偶极矩，当极性分子靠近时，会造成电性的吸引，这种作用力称为偶极-偶极力。分子的偶极矩愈大，分子间的作用力愈大。背景：动态增强MRI作为一种无创性检测方法，目前在肿瘤领域运用广泛，可进行肿瘤良恶性的鉴别、肿瘤级别的分级以及预后的预测与评估等。近年其在骨关节领域的运用研究逐渐成为热点，可用于骨髓血流灌注的测定、骨组织活性的评估、骨灌注异常的早期发现以及关节炎性病变血运的评估等。目的：总结动态增强MRI的技术概况及其目前在骨关节方面的应用进展。方法：英文检索式为“(bone OR joint) AND (dynamiccontrast-enhanced MRI) OR dynamic contrast-enhanced magnetic resonance imaging)”，中文检索式为“(骨OR关节)AND动态增强磁共振”“(骨OR关节)AND 动态增强MRI”“(骨OR关节)AND DCE-MRI”，由第一作者检索1984至2019年PubMed、Springerlink以及中国期刊全文数据库(CNKI)，查阅近年动态增强MRI在骨关节方面应用的相关文献，最终保留55篇文献进行总结分析。结果与结论：①目前动态增强MRI成像技术及数据处理尚未标准化，在骨关节主要采用T1WI成像，可行定性、半定量及全定量分析；②定性分析及半定量分析操作简便，量化指标明确，能客观地描述曲线形态，但不能反映组织间、血管内的对比剂浓度，且容易受扫描参数序列的影响，无法检测组织药物代谢动力学信息；而定量分析能获得组织内亚结构间的对比剂浓度变化并生成参数，评估组织的微血管生成及其功能；③动态增强MRI可无创性评估骨关节的微循环灌注，对许多骨关节疾病发病机制的探讨、诊断及鉴别诊断、预后预测、疗效评估以及治疗方式的选择都有一定参考价值。ORCID: 0000-0002-0093-9910(黄雪洁)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

Focused research of dynamic contrast-enhanced magnetic resonance imaging in bone and joint

BACKGROUND:As a non-invasive detection method,dynamic contrast-enhanced magnetic resonance imaging is widely used in the field of tumor.It can be used for the differentiation of benign and malignant tumors,the grading of tumor grade and the prediction and evaluation of prognosis.In recent years,the application research in the field of bone and joint has gradually become a hot spot,which can be used in the determination of bone marrow blood perfusion,the evaluation of bone tissue activity,the early detection of bone perfusion abnormality and the evaluation of blood circulation of joint inflammatory lesions.OBJECTIVE:To summarize the technical situation of dynamic contrast-enhanced magnetic resonance imaging and its application research in bone and joint.METHODS:The keywords were“(bone OR joint)AND(dynamic contrast-enhanced MRI)OR (dynamic contrast-enhanced magnetic resonance imaging)OR DCE-MRI”in English and Chinese,respectively.The first author searched PubMed,Springerlink and China National Knowledge Infrastructure databases for the articles published between 1984 and 2019.The relevant literature was reviewed on the application of dynamic contrast-enhanced magnetic resonance imaging in bone and joint in recent years.Finally,55 articles were summarized and analyzed.RESULTS AND CONCLUSION:(1)At present,dynamic contrast-enhanced magnetic resonance imaging technology and data processing have not been standardized.T1WI imaging is mainly used in bone and joint.Qualitative,semi-quantitative and full quantitative analysis of its data is feasible.(2)Qualitative analysis and semi-quantitative analysis are simple and easy to operate.Quantitative indicators are clear,can objectively describe the shape of the curve,but cannot reflect the concentration of contrast agent between tissues and blood vessels,and are easily affected by the sequence of scanning parameters,so cannot detect the pharmacokinetic information of tissue.Quantitative analysis can obtain the concentration changes and generation parameters of contrast media between substructures in tissues,and evaluate the microangiogenesis and function of tissues.(3)Dynamic contrast-enhanced magnetic resonance imaging can noninvasively evaluate the microcirculation perfusion of bone and joint.It has certain reference value for the discussion of the pathogenesis,diagnosis and differential diagnosis,prediction of prognosis,evaluation of curative effect and choice of treatment of many bone and joint diseases.