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引用次数: 0
摘要
据报道,软骨横向松弛时间(T2)对oa相关的软骨组成变化很敏感,但之前没有研究报道过有或没有ACL损伤的人的股胫(FTJ)软骨T2侧对侧差异的参考值。由于关节软骨细胞外基质具有层状组织,本研究主要关注层状(深层和浅层)T2软骨时间。目的探讨不同年龄组ACL损伤与对侧膝关节间板层软骨T2是否存在差异;2)两年龄组ACL损伤与健康对照组间膝关节间板层软骨T2是否存在差异。此外,我们报告了健康对照者膝关节间差异的层间T2阈值。方法85例受试者分为4组(健康年龄20 ~ 30岁,hea20 ~ 30岁,n=24;20 ~ 30年ACL损伤,acl20 ~ 30, n=23;40-60岁健康,HEA40-60, n=24;40-60岁ACL损伤,ACL40-60, n=14)完成数据收集。前交叉韧带损伤的参与者在纳入前2-10年有单侧交叉韧带损伤。采用定量3D DESS序列(平面分辨率0.3125*0.3125mm,层厚1.5mm,分辨率512*512,TR 17 ms, TE1 4.85ms, TE2 9.75 ms, FA 15°)获取HEA左(hea_1)和右(HEA_r)或ACL损伤(ACL_in)和未损伤(ACL_unin)侧的mri。用软骨测量仪将负重FTJ软骨板手工分割为深层50% (. d)、表层50% (. s)和总软骨(. t)。根据T2平均值(HEA_l-HEA_r或ACL_in-ACL_unin)计算FTJ膝关节间T2差异(dif_FTJ)。非参数Dunn和Conover-Iman检验分别用于组间和膝关节间比较。采用Holm校正对多重比较进行校正(P<0.05)。从健康受试者中计算80%的检测膝关节差异阈值为mean(dif_FTJ HEA20-30)±1.28*SD(dif_FTJ HEA20-30),并获得各组差异超过这些阈值的受试者人数。结果ACL_in的深T2区比ACL_unin和HEA的膝盖长(图A)。深度区dif_FTJ在ACL20-30和ACL40-60中仅比HEA20-30或HEA40-60的膝盖间差异大(图B),而浅表区dif_FTJ(图C)或总dif_FTJ(图D)则没有。对于深度区dif_FTJ,超过-1.57至1.60 ms的80%阈值限制的参与者数量HEA20-30为3/24 (12.5%),ACL20-30为15/23(65.2%)。HEA40-60为5/24 (20.8%),ACL40-60为11/14(78.6%)。结论:前交叉韧带损伤(伴或不伴前交叉韧带手术重建)后2 - 10年FTJ深区T2升高提示创伤后软骨质量降低(即软骨成分和力学改变)。两个年龄组前交叉韧带损伤后深区dif_FTJ具有可比性,表明创伤对两组软骨质量的影响相同。我们得出结论,前交叉韧带损伤的影响在T2深区最为明显,大多数前交叉韧带损伤的参与者在健康关节软骨的阈值范围之外表现出膝盖间的差异。
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