MR 擴散加權成像診斷膝關節骨關節病
髕骨軟骨病變的價值
劉斯潤 朱天緣 陳漢方 吳荷嘉
【摘要】 目的 探討MR 擴散加權成像( DWI) 在膝關節軟骨早期病變診斷中的臨床應用價值。
方法 18 例正常健康志愿者36 個膝關節、10 例骨關節炎( OA) 患者18 個膝關節行常規序列及DWI
序列掃描。測量髕軟骨各個感興趣區的表觀擴散系數( ADC) 值, 比較各組間的差異。結果 正常健
康志愿者組36 個髕軟骨ADC 均值( ADCav) 為( 7. 8 ±2. 3) × 10 - 4 mm2 / s, 髕軟骨上、中、下部的ADC
值分別為( 7. 9 ±2. 3)× 10 - 4 mm2 / s、( 7. 7 ±2. 7)× 10 - 4mm2 / s、( 7. 9 ±2. 5) × 10 - 4 mm2 / s, 之間差異無
統計學意義( F = 0. 050, P = 0. 951) 。OA 患者髕軟骨ADCav 為( 10. 5 ±4. 1 )× 10 - 4 mm2 / s, 髕軟骨上、
中、下部的ADC 值分別為( 10. 8 ±4. 1) × 10 - 4 mm2 / s、( 10. 4 ±4. 4) × 10 - 4 mm2 / s、( 10. 5 ±4. 2 ) ×
10 - 4mm2 / s, 之間差異無統計學意義( F = 0. 940, P = 0. 910) 。但OA 組的ADC 值明顯高于正常組, 兩
組間差異有統計學意義( t = - 2. 577, P = 0. 017) , 其中以髕軟骨內側份ADC 值改變最為顯著。結論
MR DWI 能發現常規MR 軟骨信號尚未改變的更早期軟骨病變。
【關鍵詞】 軟骨, 關節; 骨關節病; 膝關節; 磁共振成像; 擴散
MR diffusion weighted ima ging study on patella ca rtilage applied to osteoar thr itis of knee joint
LIU Si-run, ZHU Tian-yuan, CHEN Ha n-fang, WU He-jia. Medical Imaging Center, the First Affiliated
Hospital, Jinan University, Gua ngzhou 510630, China.
【Abstra ct 】 Objective To evaluate the clinical significance of quantitative measurement ADC value
of patella cartilage on MR diffusion weighted imaging ( DWI ) . Methods Thirty-six knees of healthy
volunteers and 18 of osteoarthritis( OA) were imaged with routine MR sequences and DWI. The ADC of each
part of patella were measured and compared with each other. Results In healthy volunteers, the ADCav of
patella cartilage was ( 7. 8 ±2. 3)× 10 - 4mm2 / s and the ADCav among superior-middle-inferior portions was
not significantly different ( F = 0. 050, P = 0. 951 ) . The ADCav of superior-middle-inferior portions was
( 7. 9 ±2. 3)× 10 - 4mm2 / s, ( 7. 7 ±2. 7 ) × 10 - 4 mm2 / s, ( 7. 9 ±2. 5 ) × 10 - 4 mm2 / s, respectively. In OA
patients, the ADCav of patella cartilage was ( 10. 5 ±4. 1) × 10 - 4 mm2 / s and the ADCav among superiormiddle-
inferior portions was not significantly different also ( F = 0. 940, P = 0. 910) . The ADCav of superiormiddle-
inferior portions was ( 10. 8 ±4. 1 ) × 10 - 4 mm2 / s, ( 10. 4 ±4. 4 ) × 10 - 4 mm2 / s, ( 10. 5 ±4. 2) ×
10 - 4mm2 / s, respectively. The ADCav of the healthy volunteers was lower than that of the OA group( t = -
2. 577, P = 0. 017) and the medial part showed the most different. Conclusion DWI is a useful method in
detecting early cartilage injury which can not be showed on routine sequences.
【Key wor ds】 Cartilage, articular; Osteoarthropathy; Knee joint; Magnetic resonance imaging;
Diffusion

MR 擴散加權成像診斷膝關節骨關節病--骨格.rar