医学论文-关节软骨病损的磁共振成像及其与组织学的对照研究.docVIP

医学论文-关节软骨病损的磁共振成像及其与组织学的对照研究 ??????????? 作者：朱宝林　亓建洪　张经健　王新怡　马振申　范克伟? 【摘要】? 　　［目的］探讨MRI对关节软骨各期病变的敏感成像序列并评价MRI对早期软骨病变的诊断价值。［方法］通过1例新鲜截肢人和4例正常猪膝关节的T2W1、PDWI、GE、STIR、3D FSFSPGR等序列的成像研究，选定最佳的序列用于6例猪骨性关节炎（Osteoarthritis,OA）模型膝关节扫描，以MRI图像为标准切取标本染色，图像与染色图片对照以评价MR对关节软骨的诊断价值。［结果］5种序列的组织分辨力、病变检出率以3D FSFSPGR序列最高分别达67.9％和93.7％；蛋白多糖（proteoglycan,PG）和胶原纤维（collagen fibers，CF）主要分布在关节软骨的深层组织。以MRI图像为标准切取的各级软骨标本之间染色浓度，PG呈递减关系，CF呈递增关系。［结论］在5种序列中，3D FSFSPGR是理想的关节软骨成像序列；MR不仅对中晚期软骨病变有良好显示，对早期软骨病变也能作出正确诊断。 【关键词】? 磁共振 关节软骨 组织学 3DFSFSPGR 　　Control study on MRI of articular cartilage erosion and its histological expression∥??? 　　Abstract：［Objective］To Study the sensitive sequence of MR for all stages of articular cartilage erosion and to evaluate the effect of MR on the correct diagnosis in the early stage of articular cartilage.［Method］One human fresh amputated knee joint and 4 normal pig knee joints were used to study and select the best sequence by T2WI,PDWI,GE,STIR,3D FSFSPGR sequences and 6 pig oatcoarthritis（OA）model knee joints were studied by the selected best sequence,MRI was compared with correspont histological evidence to evaluate the effect of MR on the correct diagnosis of OA cartilage.［Result］The best results of tissue resolution and diagnosis rate were seen in 3D FSFSPGR of all five sequences respectively 67.9% and 93.7%,of proteogly(PG) and collagen fiber(CF) mainly distributed in the deep cantilage.Dyeing of PG in diffent cantilage erosion was decreased while CF increasing.［Conclusion］3D FSFSPGR is a favorable scan sequence to examine the OA changes of articular cartilage.MRI could show the pathological changes including early stage and have good veracity to the early pathological changes of OA cartilage.??? 　　Key words：MR;? articular cartilage;? histology;? 3D FSFSPGR 　　软骨退变是OA的基础，早期发现并预防关节软骨的退变十分重要。随着磁共振技术发展，应用敏感的成像序列能否发现早期软骨病变?为此，作者设计本实验以探索MRI早期诊断关节软骨病变的有关问题，并通过与组织学比较，评价MRI的诊断价值。 　　1? 材料与方法 　　1.1? 实验设备与材料??? 　　美国GE公司1.5 T超导型永磁体MRI扫描仪SIGNA，膝线圈。即用型SABC免疫组化试剂盒；