MRI在软骨损伤中的应用价值课件.pptVIP

* * * * * The signal intensity of SE-T1WI cartilage was low and medium, and was clearly differentiated from the subchondral bone structure. The signal difference between SE-T1WI and adjacent articular fluid and synovium was insufficient to clearly distinguish the various structures SE-T2WI significantly enhanced the contrast between cartilage and articular fluid, highlighting the image of cartilage surface, while the boundary between cartilage and bone structure was not as clear as SE-T1WI Gradient echo sequence imaging (FE) showed high signal of cartilage, but poor display of adjacent structures Articular MRI imaging highlights the surface image of cartilage, which is very helpful for patients without joint effusion 3D-FFE imaging is very convenient to identify cartilage lesions, which is deceptive * * 随年龄增加，软骨厚度渐变薄。1岁或1岁内、2-16岁、17-25和25岁以上大体测量平均值分别为4.86mm、2.88mm、1.71mm和1.59mm。 儿童关节软骨中5只（83.3%）MRI呈现三层结构，出生新生儿软骨的偏光镜下区域和MRI层次 模糊不清或隐约显示各区域和层次，1-16岁软骨的偏光镜区域和MRI层次均非常清晰。 成年人软骨的偏光镜分区清晰，但仅16.7%软骨MRI显示三层结构 ，余均为单层 * 软骨下骨结构改变可源于软骨病变或骨结构本身病变继而发生软骨病变。若是软骨病变在先，缺乏软骨保护的骨结构随即发生反应性增生、水肿和缺血，若软骨出现裂缝，关节液渗入软骨下，骨结构内形成囊肿或疤痕形成，也可以出现滑膜直接查长入软骨下，破坏骨结构。 * Common in adolescents There are significantly more men than women About 50% of cases have a clear history of trauma It is mainly located on the non-bearing surface of the medial femoral condyle * In stage Ⅰ, the lesion was 1-3cm in size, and the cartilages were basically intact Stage Ⅱ cartilage defect, no obvious defect of bone structure, no free body Stage III cartilage with partial bone structure dissection, with or without scar tissue In stage Ⅳ, the bone cartilage was completely exfoliated and formed a pit filled with granulation and free bodies * * 1期剥脱性骨软骨炎病例，覆盖在病灶上的软骨完整，MRI显示软骨表面光整，各部分软骨厚度基本一致，T1，2WI为中等或低信号，软骨内可呈现三层结构。由于软骨层菲薄，易受到各种因素的影响，如年龄、容积效应、化学位移、各向异性等因素均会影响软骨厚度、改变软骨信号强度和层次的显示，因此软骨轻微的信号改变、厚度改变、形态改变和层次消失通常无意义。 * 2期仅有轻度软骨缺损，MRI呈现为软骨表面毛糙、局限性凹陷、其厚度明显变厚或变薄、软骨T2WI信号明显升高和软骨内下出现裂隙。尽管少数完整软骨也可能呈现表面毛糙、凹陷或厚度变化中的某一种征象，多为各种因素的干