摘要
目的:探讨早期股骨头坏死关节软骨的改变,为深入了解股骨头坏死的病理机制及制定合理治疗提供实验与临床依据。方法:采用软骨延迟增强核磁成像(delayed gado1inium-enhanced magnetic resonance i maging ofcartilage-dGEMRIC)技术,对Ⅱ、Ⅲ期成人股骨头坏死的关节软骨进行检测。20髋激素性股骨头坏死患者中,以国际骨坏死与循环协会(ARCO)分期标准,股骨头坏死Ⅱ期患者为11髋,股骨头坏死Ⅲ期患者为9髋,5名健康志愿者作测试为对照组。对每名受试者进行钆增强延迟核磁共振(1.5T)扫描,分别获得T1Gd数据,应用Matlab和mri mapper软件对每位受试者的影像数据进行分析。结果:股骨头坏死Ⅱ期患者的MRITl Gd值(441.13士41.32)与健康志愿者的T1Gd值(544.2士27.83)有显著差别(P<0.001)。股骨头坏死Ⅲ期患者的T1Gd值(363,11士56.39)与健康志愿者的T1Gd值也有显著差别(P<0.001)。股骨头坏死Ⅲ期与股骨头坏死Ⅱ期患者的T1Gd值比较下降17.7%,两者有显著性差别(P<0.05)。结论:股骨头坏死早期患者的关节软骨已经开始发生代谢变化。说明骨坏死早期可以影响软骨的代谢和功能,并随着坏死程度加重而加大。
objective：To detect me articular cartilage change of hip joint at early stage of the osteonecrosis femural head（ONFH）,provided theoretic evidence for understanding the pathomechanism of ONFH and performing rational therapy.Methods：The articular cartilage changes of stage Ⅱ 、Ⅲ of ONFH were determined by delayed gadolinium-enhanced magnetic resonance imaging of cartilage.5 asymptomatic volunteers and 20 patients with ONFH participated in the test.According to ARCO classification of ONFH,stage Ⅱ in 11 cases,stage Ⅲ in 9 cases,they were all steroid type.All participant underwent the tests by MRI（1.5T）,and the data of T1Gd were collected and analyzed by means of Matlab and mrimapper software.Results：The values of T1Gd obtained from the patients with stage Ⅱ,Ⅲ ONFH,and the healthy volunteers were 441.13士41.32,363.11士56.39,and 544.2士27.83 respectively.The values of Tl Gd in the patients of stage Ⅱ,Ⅲ ONFH were lower than in volunteers,there was a significant diference in TlGd between the patients of stage Ⅱ or Ⅲ and the healthy volunteers（PO.001）.The values of TlGd of the patients of stage Ⅲ was 17.7% lower than the patients of stage Ⅱ,and the difference between two stages was significant statistically（PO.05）.Conclusion：At early stage of ONFH,articular cartilage of the femoral head appears abnormal metabolic changes,represented by the loss of GAG in the articular cartilage,and aggravated as worsening of ONFH.This demonstrates the metabolism and function of the articular cartilage can be influenced at early stages of ONFH,but the mechanism is not clear and further study is needed.
出处
《中国伤残医学》
2010年第4期8-10,共3页
Chinese Journal of Trauma and Disability Medicine
