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目的探讨磁共振T2-mapping和3D-SPGR技术在评估膝关节基质诱导自体软骨细胞移植术后软骨修复的作用。方法 9例膝关节软骨损伤患者,接受自体软骨细胞移植术治疗,在术后不同时间进行临床Lysholm评分评价,同时行磁共振检查。测量各时间点移植区与正常区软骨全层的T2值,并计算移植区与正常区软骨T2比值Z;移植软骨各时间点厚度及周围正常软骨厚度,并进行统计学分析。各个时间点移植区与正常区T2值比较采用配对t检验,Z值与Lysholm评分采用Spearman秩和检验。结果术后移植区T2值均大于正常区,移植软骨均增厚。各个时间点移植区与正常区T2值配对t检验差异有统计学意义(P=0.004);Z值与Lysholm评分有统计学意义(r=-0.645,P=0.017)。随着术后时间的延长,移植区T2值降低,软骨厚度增加。结论磁共振T2-mapping联合3D-SPGR能够无创、动态地监测自体软骨细胞移植术后软骨的修复过程,可作为软骨修复术后评估的重要工具。
Objective To investigate the effect of magnetic resonance T2-mapping and 3D-SPGR in the evaluation of cartilage repair after autologous chondrocyte transplantation. Methods Nine patients with knee joint cartilage injury were treated with autologous chondrocyte transplantation. The clinical Lysholm score was evaluated at different time points after operation, and magnetic resonance imaging was performed simultaneously. T2 values of cartilage in allograft and normal areas were measured at each time point, and the T2 ratio of cartilage in the transplantation area and the normal area was calculated. The thickness of the cartilage at each time point and the surrounding normal cartilage thickness were calculated and analyzed statistically. The T2 values of the transplantation area and the normal area at each time point were compared by paired t-test and the Z value and Lysholm score by Spearman’s rank sum test. Results The T2 value of the postoperative transplantation area was larger than that of the normal area, and the cartilage was thicker. There was significant difference between T2 value paired t test at each time point (P = 0.004). There was significant difference between Z value and Lysholm score (r = -0.645, P = 0.017). With the extension of postoperative time, the T2 value of the graft decreased and the cartilage thickness increased. Conclusion Magnetic resonance T2-mapping combined with 3D-SPGR can monitor the repair process of cartilage after autologous chondrocyte transplantation noninvasively and as an important tool for the postoperative evaluation of cartilage repair.