膝关节软骨下BMLs与软骨下骨承受应力改变关系的研究

doi:10.12117/jccmi.2018.11.012

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摘要目的：通过研究膝关节稳固结构与软骨下骨髓水肿样病变（BMLs）的关系，探讨膝关节软骨下骨应力改变及其它因素对膝关节软骨下BMLs的影响。方法：对281例膝关节应力改变组和26例结构正常组进行MRI检查。对每个膝关节的MRI进行修订后的WORMS评分，评分对象包括膝关节软骨、半月板、韧带（主要是前、后交叉韧带和内、外侧副韧带）、骨髓水肿等。在应力改变组内将膝关节稳固结构损伤与完整时BMLs的出现率做对比分析。对半月板撕裂、突出与BMLs的关系做了秩相关检验。对影响BMLs范围的关节内异常结构及可能的危险因素做了Logistic回归分析。结果：应力改变组较结构正常组BMLs出现率高，有软骨损伤的较没有软骨损伤的，稳固韧带损伤较没有损伤的BMLs出现率高。半月板撕裂、突出与BMLs的大小成正相关。内侧半月板前角突出对股骨内髁BMLs范围影响最大，依次是内侧半月板前角撕裂、股骨内髁软骨损伤和年龄。胫骨内髁软骨损伤对胫骨内髁BMLs范围影响最大，依次是内侧半月板前角撕裂和年龄。股骨外髁软骨损伤对股骨外髁BMLs范围影响最大，然后是年龄。胫骨外髁软骨损伤对胫骨外髁BMLs范围影响最大，然后是外侧半月板前角撕裂。软骨损伤对总BMLs病变范围影响最大，依次是半月板损伤和年龄。结论：关节稳固结构损伤会导致膝关节软骨下BMLs的产生，其中软骨损伤起主要作用。

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	王晶1
	崔建岭2
	赵建2
	任进军3
	王伟秀1

关键词 ：膝关节, 软骨疾病, 磁共振成像

Abstract：Objective: To explore the contribution of the stabilizing structures of the knee and other stress factors to the subchondral bone marrow edema-like lesions(BMLs) of the knee by evaluating the relationship between stabilizer failure of the subchondral bone and the BMLs of the knee. Methods: The stabilizer failure group with 281 cases and the normal structure group with 26 cases were tested by MR. MR images were graded by WORMS, including the cartilage, the meniscus, the ligaments(the anterior and posterior cruciate ligament, the medial and lateral collateral ligament), bone marrow edema. The presence of subchondral BMLs between the stabilizing structures defect and normal in the stabilizer failure group were compared and analyzed. The relationship between the meniscus tear or extrusion and the BMLs were tested by Rank correlation. The abnormality of the stabilizing structures and possible risk factors affected the size of subchondral BMLs were tested by logistic regression method. Results: The presence of BMLs was significantly higher in patients with stress changed group than normal structure group. The presence of BMLs was significantly higher in patients with cartilage defect than normal. The presence of BMLs was significantly higher in patients with the stabilizer ligaments tear than normal. The range of MFC BMLs is mainly affected by the anterior horn of the medial meniscus extrusion, and followed by the anterior horn of the medial meniscus tear, MFC cartilage defect and age. The range of MT BMLs is mainly affected by MT cartilage defect, and followed by the anterior horn of the medial meniscus tear and age. The range of LFC BMLs is mainly affected by LFC cartilage defect, and followed by the age. The range of LT BMLs is mainly affected by LT cartilage defect, and followed by the anterior horn of the lateral meniscus tear. The range of the gross BMLs is mainly affected by cartilage defect, and followed by the meniscus abnormality and age. Conclusion: Articular stabilizer structure defect would induce the formation of subchondral BMLs, and the main actor was the cartilage defect.

Key words： Knee joint Cartilage diseases Magnetic resonance imaging

收稿日期: 2017-12-11

PACS:	Ｒ681.3
	Ｒ445.2

通讯作者: 崔建岭，河北医科大学第三医院CT/MR科，050000。E-mail：jianlingcui@sina.com

作者简介: 王晶（1983-），女，河北保定人，主治医师。E-mail：wangjing2006321@126.com

引用本文:

王晶1，崔建岭2，赵建2，任进军3，王伟秀1. 膝关节软骨下BMLs与软骨下骨承受应力改变关系的研究[J]. 中国临床医学影像杂志, 2018, 29(11): 818-821.
WANG Jing1, CUI Jian-ling2, ZHAO Jian2, REN Jin-jun3, WANG Wei-xiu1. The association between BMLs of the subchondral bone and stabilizer failure in knee joint. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(11): 818-821.

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http://www.jccmi.com.cn/CN/10.12117/jccmi.2018.11.012 或 http://www.jccmi.com.cn/CN/Y2018/V29/I11/818

[1]崔建岭，任进军，孙英彩，等. 膝关节软骨下骨局灶性病变与应力改变的相关性研究[J]. 临床放射学杂志，2009，28（4）：540-544. [2]任进军，崔建岭. 膝关节自发性骨坏死的研究现状[J]. 国外医学：临床放射学分册，2006，29（4）：401-404. [3]崔建岭，任进军，孙英彩，等. 膝关节自发性骨坏死的MRI诊断（附15例报告）[J]. 实用放射学杂志，2008，24（7）：940-942. [4]Peterfy CG, Uermazi A, Aim S, et al. Whole-organ magnetic resonance imaging score(WORMS) of the knee in osteoarthritis[J]. Osteoarthr Cartil, 2004, 12(3): 177-190. [5]Hunter DJ, Zhang YQ, Niu JB, et al. Association of meniscal pathologic changes with cartilage loss in symptomatic knee osteoarthritis[J]. Arthr Rheum, 2006, 54(3): 795-801. [6]Madan-Sharma R, Kloppenburg M, Kornaat PR, et al. Do MRI features at baseline predict radiographic joint space narrowing in the medial compartment of the osteoarthritic knee 2 years later?[J]. Skelet Radiol, 2008, 37(9): 805-811. [7]Kazakia GJ, Kuo D, Schoiller J, et al． Bone and cartilage demonstrate changes localized to bone marrow edema-like lesions within osteoarthritis knees[J]． Osteoarth Cartil, 2013, 21(1): 94-101. [8]方舒，邢伟. T2弛豫时间图在膝关节软骨下骨髓水肿与软骨损伤相关性研究中的应用[J]. 中国中西医结合影像学杂志，2015，13（4）：367-369. [9]王建军. 膝关节骨关节炎软骨下骨髓水肿与膝关节内外侧骨密度的相关性[J]. 中国现代医生，2014，52（9）：65-67. [10]苏凯，吴家林，庞慧芳，等．膝关节骨关节炎MRI表现[J]. 医学影像学杂志，2011，21（7）：1072-1075. [11]李西海，梁文娜. 软骨下骨重塑与骨关节炎的关系[J]. 国际骨科学杂志，2007，28（1）：35-37. [12]李敏，梁翼，吴晓惠，等．伴骨髓水肿的膝骨关节炎患者白细胞介素1β白细胞介素6肿瘤坏死因子α的相关性研究[J]．中华风湿病学杂志，2012，16（2）：107-110. [13]Papageorgiou CD, Gil JE, Kanamori A, et al. The biomechanical interdependence between the anterior cruciate ligament replace-ment graft and the medial meniscus[J]. Am J Sport Med, 2001, 29(2): 226-231. [14]李康华，罗令，雷光华，等. 前交叉韧带不同断裂程度对内侧半月板后角生物力学特性的影响[J]. 现代生物医学进展，2008，8（8）：1488-1491.