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目的探讨d GEM RIC用于诊断早期髌骨软化症的可行性和价值。方法选取41例早期髌骨软化症患者,先行3D-FSSPGR系列平扫检查,经肘静脉注射钆喷酸葡胺后步行10min使对比剂尽量弥散至髌关节软骨内,注射后2h再行3DFS-SPGR延迟增强对关节软骨进行评价,并将检查结果与关节镜检查结果进行对照。结果 3D-FS-SPGR系列上正常髌软骨呈明显带状高信号,并可见高-低-高三层结构;软骨损伤在3D-FS-SPGR上呈相对稍低信号,在d GEM RIC系列上呈局灶高信号;3D-FS-SPGR序列平扫对Ⅰ期髌软骨损伤显示的符合率为36.8%(7/19),对Ⅱ期髌骨软化病变符合率为50%(11/22),延迟增强扫描对Ⅰ期髌骨软化病变符合率为73.7%(14/19),对Ⅱ期髌骨软化病变符合率为86.4%(19/22)。经t检验,髌软骨Ⅰ、Ⅱ期损伤的延迟增强扫描诊断符合率均明显高于平扫(Ⅰ期t=2.646,P=0.016;Ⅱ期t=2.531,P=0.017)。结论 3D-FS-SPGR延迟增强扫描判断髌软骨早期损伤比平扫更敏感,是一种诊断早期髌骨软化症的有优势的、无创的方法。
Objective To investigate the feasibility and value of d GEM RIC in the diagnosis of early chondromalacia patellae. Methods 41 patients with early chondromalacia patellae were enrolled in this study. The 3D-FSSPGR series of plain scans were performed before the contrast agent was dispersed into the patellar cartilage via the elbow vein injection of gadopentetate dimeglumide. 3DFS-SPGR Delayed enhancement of articular cartilage evaluation, and examination results and arthroscopy results were compared. Results The normal patellofemoral cartilage in 3D-FS-SPGR series showed obvious ribbon-shaped high signal and high-low-high three-layer structure. Cartilage injury showed a relatively lower signal on 3D-FS-SPGR, The coincidence rate of 3D-FS-SPGR sequence scan for stage Ⅰ patellar cartilage injury was 36.8% (7/19), and the coincidence rate of 50% (11/22) for stage Ⅱ patella softening lesion was delayed The coincidence rate of enhanced scan was 73.7% (14/19) for stage Ⅰ chondromalacia patellae, and 86.4% (19/22) for stage Ⅱ chondromalacia patellae. The t test showed that the coincidence rate of delayed enhancement scan of patellar cartilage Ⅰ and Ⅱ lesions were significantly higher than that of plain scan (Ⅰ = 2.646, P = 0.016; Ⅱ = t = 2.531, P = 0.017). Conclusion 3D-FS-SPGR delay enhanced scan to determine the early damage of patella cartilage is more sensitive than the scan, is an early diagnosis of chondromalacia patellae, noninvasive method.