膝关节骨性关节炎临床症状与MR影像表现的相关性研究(1)
【摘要】目的：回顾性分析膝关节骨性关节炎患者的临床症状表现特征与MR影像显示膝关节结构异常之间的相关性。材料和方法：对110例具有膝关节疼痛或关节晨僵，被临床诊断为骨性关节炎病人的膝关节进行MR检查，其中男性35例，女性75例，年龄45~86岁，平均年龄61.7岁。所有进行膝关节MR检查的病人均有膝关节疼痛、关节晨僵等症状。对膝关节MR影像的各种异常表现进行分析描述，并对MR影像异常表现和膝关节骨性关节炎临床特征进行统计学分析，以明确两者之间的相关性。结果：结果显示膝关节疼痛和关节晨僵与关节内中、大量的关节渗液相关；骨髓水肿、中央性骨赘可导致膝关节疼痛；MR影像的其它异常表现如局灶或弥漫性软骨异常、软骨下囊肿、半月板损伤等与其临床症状在统计学上无明显联系。结论：本组病例研究结果显示膝关节骨性关节炎患者只有三种MR影像的异常结构与临床症状相关。
【关键词】骨质结构；关节炎
Knee joint bonenature arthritis clinical symptom and MR image performance relevant research
SHI Tiang-liang1 LIUYong-shan2
【Abstract】Objeetive:Review analysis knee joint bonenature arthritis patient’s clinical symptom performance characteristic and MR image demonstration knee joint structure exceptionally between relevance. Material and method: Has the knee joint ache or the joint early morning to 110 examples is stiff, is carried on by the clinical diagnosis for bonenature the arthritis patient’s knee joint the MR inspection, masculine 35 examples, feminine 75 examples, age 45~86 year old, average age 61.7 years old. All average per person carries on the knee joint MR inspection sickness to have the knee joint ache, the joint early morning is stiff and so on the symptom. Exceptionally displays to knee joint MR image each kind carries on the analysis description, and exceptionally displays and the knee joint bonenature arthritis clinical characteristic to the MR image carries on statistics analysis, is clear about two between the relevance. Result：The result showed the knee joint ache and the joint early morning stiffly with the joint in center, the massive joints infiltrate the fluid to be related; The marrow dropsy, the central bone is superfluous may cause the knee joint ache; MR image other exceptionally display like the bureau stove or the filling the air cartilage exceptionally, under the cartilage the cyst, the meniscus damage and so on if the clinical symptom not obviously relates in statistics. Conclusion: This group of case of illness findings showed the knee joint bonenature arthritis patient only has three kind of MR image the unusual structure and the clinical symptom is related.
【Key words】Ossein structure; Arthritis
骨性关节炎(osteoarthrosis, OA)，又称退行性骨关节病、肥大性关节炎，是一种非炎症性慢性进行性关节疾病，多见于老年人，是最常见的一种关节病[1]。
常规X片可以显示膝关节的骨质结构，如骨皮质、骨小梁及骨赘形成等，尚可判断测量关节间隙的宽窄，然而不能显示关节内及其周围软组织结构，所以其不能用于骨关节炎和其临床症状的相关性分析研究。MR影像具有较高的软组织分辨率，并可以多层面、多轴位成像，可以清晰地显示关节软骨、关节囊、半月板、滑膜、韧带、肌肉等软组织[2～4]。所以可以用于判定膝关节骨性关节炎和其临床症状之间的关系如关节疼痛、关节晨僵等。本文的目的是对膝关节骨性关节炎的MR影像异常表现和其典型临床症状之间的相关性进行分析。
1 材料和方法
1.1 病人与临床表现：本组病例共收集110例膝关节骨性关节炎患者，其中男性35例，女性75 例。年龄45-86岁，平均61.7岁。病程最短6个月，最长23年。病变部位:单侧膝关节或双膝关节。主要临床症状表现为受累膝关节的疼痛、肿胀、晨僵、关节积液及骨性肥大等。
1.2 MR成像技术：所有的病人均进行磁共振成像检查使用MINOIT 1.5T超导型磁共振机，应用表面线圈，扫描序列：T1WI：SE序列，TR/TE=450/14ms，FOV=200mm，矩阵=256X192,层厚/间距=4.0/10mm；T2WI：TSE序列,TR/TE=3000/100ms，FOV=200mm，矩阵=256X192,层厚/间距=4.0/10mm；T2*WI序列：FOV=220mm,TR/TE=480/13ms, 层厚/间距=4.0/1.0mm,矩阵=256X160。行冠状位及矢状位扫描。
1.3 MR影像分析：MR影像主要观察、分析软骨损伤、骨赘、软骨下囊肿和骨髓水肿等表现，查找有无内、外侧半月板及韧带的损伤、关节渗液、滑膜炎、腘窝囊肿等异常表现。发现其中软骨损伤80例，骨赘86 例，中央骨赘31例，软骨下囊肿44例，骨髓水肿56例，半月板损伤71例，关节渗液62例，腘窝囊肿29例。, http://www.100md.com
【关键词】骨质结构；关节炎
Knee joint bonenature arthritis clinical symptom and MR image performance relevant research
SHI Tiang-liang1 LIUYong-shan2
【Abstract】Objeetive:Review analysis knee joint bonenature arthritis patient’s clinical symptom performance characteristic and MR image demonstration knee joint structure exceptionally between relevance. Material and method: Has the knee joint ache or the joint early morning to 110 examples is stiff, is carried on by the clinical diagnosis for bonenature the arthritis patient’s knee joint the MR inspection, masculine 35 examples, feminine 75 examples, age 45~86 year old, average age 61.7 years old. All average per person carries on the knee joint MR inspection sickness to have the knee joint ache, the joint early morning is stiff and so on the symptom. Exceptionally displays to knee joint MR image each kind carries on the analysis description, and exceptionally displays and the knee joint bonenature arthritis clinical characteristic to the MR image carries on statistics analysis, is clear about two between the relevance. Result：The result showed the knee joint ache and the joint early morning stiffly with the joint in center, the massive joints infiltrate the fluid to be related; The marrow dropsy, the central bone is superfluous may cause the knee joint ache; MR image other exceptionally display like the bureau stove or the filling the air cartilage exceptionally, under the cartilage the cyst, the meniscus damage and so on if the clinical symptom not obviously relates in statistics. Conclusion: This group of case of illness findings showed the knee joint bonenature arthritis patient only has three kind of MR image the unusual structure and the clinical symptom is related.
【Key words】Ossein structure; Arthritis
骨性关节炎(osteoarthrosis, OA)，又称退行性骨关节病、肥大性关节炎，是一种非炎症性慢性进行性关节疾病，多见于老年人，是最常见的一种关节病[1]。
常规X片可以显示膝关节的骨质结构，如骨皮质、骨小梁及骨赘形成等，尚可判断测量关节间隙的宽窄，然而不能显示关节内及其周围软组织结构，所以其不能用于骨关节炎和其临床症状的相关性分析研究。MR影像具有较高的软组织分辨率，并可以多层面、多轴位成像，可以清晰地显示关节软骨、关节囊、半月板、滑膜、韧带、肌肉等软组织[2～4]。所以可以用于判定膝关节骨性关节炎和其临床症状之间的关系如关节疼痛、关节晨僵等。本文的目的是对膝关节骨性关节炎的MR影像异常表现和其典型临床症状之间的相关性进行分析。
1 材料和方法
1.1 病人与临床表现：本组病例共收集110例膝关节骨性关节炎患者，其中男性35例，女性75 例。年龄45-86岁，平均61.7岁。病程最短6个月，最长23年。病变部位:单侧膝关节或双膝关节。主要临床症状表现为受累膝关节的疼痛、肿胀、晨僵、关节积液及骨性肥大等。
1.2 MR成像技术：所有的病人均进行磁共振成像检查使用MINOIT 1.5T超导型磁共振机，应用表面线圈，扫描序列：T1WI：SE序列，TR/TE=450/14ms，FOV=200mm，矩阵=256X192,层厚/间距=4.0/10mm；T2WI：TSE序列,TR/TE=3000/100ms，FOV=200mm，矩阵=256X192,层厚/间距=4.0/10mm；T2*WI序列：FOV=220mm,TR/TE=480/13ms, 层厚/间距=4.0/1.0mm,矩阵=256X160。行冠状位及矢状位扫描。
1.3 MR影像分析：MR影像主要观察、分析软骨损伤、骨赘、软骨下囊肿和骨髓水肿等表现，查找有无内、外侧半月板及韧带的损伤、关节渗液、滑膜炎、腘窝囊肿等异常表现。发现其中软骨损伤80例，骨赘86 例，中央骨赘31例，软骨下囊肿44例，骨髓水肿56例，半月板损伤71例，关节渗液62例，腘窝囊肿29例。, http://www.100md.com