软骨延迟增强磁共振成像在关节疾病中的应用The progession of application of delayed gadolinium-enhanced magnetic resonance imaging of cartilage on joint diseases
徐广春;程立明;郭万首;
摘要(Abstract):
软骨延迟增强磁共振成像(delayed gadolinium-enhanced MRI of cartilage,dGEMRIC)是一种分子成像技术,借助增强剂钆喷酸葡胺(Gd-DTPA2)的存在,利用计算机图像处理软件,将获得的T1值绘制成T1图像,用以评价关节软骨中糖胺聚糖(glycosaminoglycan,GAG)的分布状况[1]。Bashir等于上世纪90年代经过实验证实,静脉注射Gd-DTPA2经过一段时间后,Gd-DTPA2可分布至关节软骨,通过MRI成像所测T1值与软骨中GAG含量呈正相关,从而为dGEMRIC技术奠定了初步的理论基础[2-3]。近年来dGEMRIC逐步开始应用于检测早期骨性关节炎软骨退变[4]、股骨头坏死[5]及髋关节发育不良[6]所造成的关节软骨损害、自体软骨细胞移植后疗效评估[7]及关节外伤软骨改变[8]等。本文主要对dGEMRIC技术主要原理、临床应用进展等方面进行综述。
关键词(KeyWords): 延迟增强磁共振;软骨;关节疾病
基金项目(Foundation):
作者(Author): 徐广春;程立明;郭万首;
Email:
DOI:
参考文献(References):
- [1]Gray ML,Burstein D,Kim YJ,et al.2007 Elizabeth Winston Lanier Award winner.Magnetic resonance imaging of cartilage glycosaminoglycan:basic principles,imaging technique,and clinical applications[J].Orthop Res,2008,3:281-291.
- [2]Bashir A,Gray ML,Burstein D.Gd-DTPA2-as a measure of cartilage degradation[J].Mag Reson Med,1996,36:665-673.
- [3]Bashir A,Gray ML,Hartke J,et al.Nondestructive imaging of human cartilage glycosaminoglycan concentration by MRI[J].Mag Reson Med,1999,41:857-865.
- [4]van Tiel J,Bron EE,Tiderius CJ.Reproducibility of3D delayed gadolinium enhanced MRI of cartilage(dGEMRIC)of the knee at 3.0 T in patients with early stage osteoarthritis[J].Eur Radiol,2013,23:496-504.
- [5]刘朝晖,郭万首,杨东,等.软骨延迟增强核磁成像法检测Ⅱ期、Ⅲ期股骨头坏死软骨改变[J].中华医学杂志,2011,21:1467-1470.
- [6]Xu L,Su Y,Kienle KP.Evaluation of radial distribution of cartilage degeneration and necessity of pre-contrast measurements using radial dGEMRIC in adults with acetabular dysplasia[J].BMC Musculoskelet Disord,2012,13:212.
- [7]Domayer SE,Trattnig S,Stelzeneder D,Delayed gadolinium-enhanced MRI of cartilage in the ankle at 3 T:feasibility and preliminary results after matrix-associated autologous chondrocyte implantation[J].Magn Reson Imaging,2010,3:732-739.
- [8]Vasiliadis HS,Danielson B,Ljungberg M,et al.Autologous chondrocyte implantation in cartilage lesions of the knee:long-term evaluation with magnetic resonance imaging and delayed gadolinium-enhanced magnetic resonance imaging technique[J].Am J Sports Med,2010,5:943-949.
- [9]Burstein D,Velyvis J,Scott KT.Protocol issues for delayed Gd(DTPA)2)-enhanced MRI(dGEMRIC)for clinical evaluation of articular cartilage[J].Magn Reson Med,2001,45:36-41.
- [10]Van Ginckel A,Baelde N,Almqvist KF,et al.Functional adaptation of knee cartilage in asymptomatic female novice runners compared to sedentary controls.A longitudinal analysis using delayed gadolinium enhanced magnetic resonance imaging of cartilage(dGEMRIC)[J].Osteoarthritis Cartilage,2010,12:1564-1569.
- [11]Anandacoomarasamy A,Giuffre BM,Leibman S,et al.Delayed gadoliniumenhanced MRI of cartilage:clinical associations in obese adults[J].Rheumatology,2009,5:1056-1062.
- [12]Jessel RH,Zilkens C,Tiderius C,et al.Assessment of osteoarthritis in hips with femoroacetabular impingement using delayed gadolinium enhanced MRI of cartilage[J].Magn Reson Imaging,2009,5:1105-1110.
- [13]Guermazi A,Roemer FW,Burstein D,et al.Why radiography should no longer be considered a surrogate outcome measure for longitudinal assessment of cartilage in knee osteoarthritis[J].Arthritis Res Ther,2011,13:247.
- [14]Debi R,Robinson D,Agar G,et al.GAG for osteoarthritis of the knee a prospective study[J].Harefuah,2000,6:451-453,518.
- [15]Williams A,Sharma L,McKenzie CA,et al.Delayed gadolinium-enhanced magnetic resonance imaging of cartilage in knee osteoarthritis:findings at different radiographic stages of disease and relationship to malalignmen[J].Arthritis Rheum,2005,11:3528-3535.
- [16]Neuman P,Tjornstrand J,Svensson J,et al.Longitudinal assessment of femoral knee cartilage quality using contrast enhanced MRI(dGEMRIC)in patients with anterior cruciate ligament injury comparison with asymptomatic volunteers[J].Osteoarthritis Cartilage,2011,8:977-983.
- [17]Kim YJ,Jaramillo D,Millis MB,et al.Assessment of early osteoarthritis in hip dysplasia with delayed gadolinium-enhanced magnetic resonance imaging of cartilage[J].Bone Joint Suer Am,2003,85:1987-1992.
- [18]Kim SD,Jessel MR.Anterior delayed gadolinium-enhanced MRI of cartilage values predict joint failure after periacetabular osteotomy[J].Clin Orthop,2012,470:3332-3341.
- [19]Siebelt M,Groen HC,Koelewijn SJ,et al.Increased physical activity severely induces osteoarthritic changes in knee joints with papain induced sulphate-glycosaminoglycan depleted cartilage[J].Arthritis Res Ther,2014,1:32.
- [20]Naveen SV,Ahmad RE,Hui WJ,et al.Histology,glycosaminoglycan level and cartilage stiffness in monoiodoacetate-induced osteoarthritis:comparative analysis with anterior cruciate ligament transection in rat model and human osteoarthritis[J].Int J Med Sci,2013,1:97-105.
- [21]Minas T,Gomoll AH,Solhpour S,et al.Autologous chondrocyte implantation for joint preservation in patients with early osteoarthritis[J].Clin Orthop,2010,468:147-157.
- [22]Gillis A,Bashir A,McKeon B,et al.Magnetic resonance imaging of relative glycosaminoglycan distribution in patients withautologous chondrocyte transplants[J].Invest Radiol,2001,12:743-748.
- [23]Nojiri T,Watanabe N,Namura T,et al.Utility of delayed gadolinium-enhanced MRI(dGEMRIC)for qualitative evaluation of articular cartilage of patellofemoral joint[J].Knee Surg Sports Traumatol Arthrosc,2006,8:718-723.
- [24]Tiderius CJ,Jessel R,Kim YJ,et al.Hip dGEMRIC in asymptomatic volunteers and patients with early osteoarthritis the influence of timing after contrast injection[J].Magn Reson Med,2007,4:803-805.
- [25]罗健,刘婧,王霄英,等.静脉注射对比剂钆喷替酸葡甲胺对肾功能正常及轻、中度异常者近期血清肌酐值的影响[J].中华放射学杂志,2010,12:1253-1257.
- [26]Idée JM,Port M,Dencausse A,et al.Involvement of gadolinium chelates in the mechanism of nephrogenic systemic fibrosis:an update[J].Radiol Clin North Am,2009,5:855-869.