Comparative Research Of Chronic Trauma Of Knee Joint Cartilage Between MRI And Arthroscope

Chronic trauma of cartilage in the knee joints is a familiar orthopaedics disease which points to the denaturalization,fibrosis,avulsion and so on in the .hyaline cartilage of knee joints under chronic,Low-grade injury force。It's hard for the trauma to recover by the self. The prognostic lies on whether or not the trauma has been early diagnosed and treated, and the prognostic is directly connected with the quality of life qol of the sufferers,therefore,searching method .in a variety of ways for an early diagnosis of Chronic trauma of cartilage in the knee joints is the object of a prolonged endeavor. Early diagnosis of Chronic trauma of cartilage in the knee joints mostly rely on the clinic manifestation and signs of sufferers, also laboratory examination and simple imaging text. Primeval. imaging text. mainly is plain film radiography,the prevailing imaging findings is dissimilitude narrows,dissymmetrys of knee joints and coarseness of articular surface. whereas foe a majority of early sufferers there is no exceptional finding on plain film radiography,which lead to difficulty for diagnosis. Along with the appearances of image equipments and the advance of level of doctors,CT,MRI had been applied to clinic gradually,especially MRI which makes clear display of the cartilage in the knee joints possible. This study uses five MRI serials for scanning 36 sufferers of Chronic trauma of cartilage in the knee joints, and Arthroscope examinations ,then contrasts the results, discusses the diagnosis value of MRI in the Chronic trauma of cartilage in the knee joints. The results of this study not only shows that there is no different between MRI examination result and Arthroscope examinations result in the discover of the number of trauma, but also particularly compares the conformities of diagnosis capacity of the five MRI series relative to Arthroscope, providing guidance for future choice of relevant MRI series.Object:Analysis the findings on different MRI series of chronic trauma of cartilage in the knee joints and compare them with Arthroscope examination results , discuss MRI the diagnosis value of MRI in the Chronic trauma of cartilage in the knee joints.Materials and methods:Collects 36 cases altogether 54 knee joints,male :30 ,45 knee joints,female 6,9 knee joints,age: 16-48,average age:35 course of diseases :6months-12years.Method:adopt 1.5TMR scanner,use knee joints exterior loop and chose five different MRI series(T1WI,FS-T2WI,FS-PDWI, FS-3D-SPGR,FS-GRET2*)to scan 36 cases altogether 54 knee joints MR images are read by experienced radiologists,who partitioned knee joints to six parts: patella, thighbone trochlea,inner femromal condyl,outer femromal condyl,inner tibial plateau ,outer tibial plateau ,in which the abnormal are carefully classified. the standard of classification is Recht's standard。Arthroscope examinations are operated by experienced orthopedists,by former inside and outside ways.The results are classified thereunder Oterbridge'standard. Compare and analyse MRI results with Arthroscope examinations resuls of the 36 cases. The classification is judged by DB(double blind)method by radiologists and orthopedists.Result : 54 knee joints altogether 324 articular surface, Arthroscope examination discovered 6 cases altogether 287 pathological changes of different dgrees of which class 0:55,classII:91,classIII:81个,classIV51,the other 8cases ,46 articular surfaces are not remarkable. The number of cartilage traumas and the degrees is different in different MR serials. Compare the results between MRI and Arthroscope ,after statistics prove,the two is of no notable difference in numbers of discovery of pathological changes. Figure out:①the sensitivity , specificity, accuracy of different series by statistics prove,②the conformity of the degrees of knee joint changes in different series occurding to Arthro -scope ,and the average conformity,There is/ no statistics differentia.Discuss: Different abnormal of knee joints can be find in MR images according to different classyfications: The early change after trauma of joint cartilage is decrease of proteoglycan in cartilage .The boost up of hydration and the lack of T2 shorten effect of collagenous fiber result in the heighten of signal in damaged cartilage,these changes in cartilage is happen early to morphological changes . Cartilage coloboma in every MRI series are of low signal ,asymmetrical signals can be find in cartilage on early stage ,and abnormity, attenuation, breach, lose and exfoliate of cartilage, exposure of bone under cartilage, cystiform high signal in bone under Cartilage afterwards .When edema occurs in cartilage,it incrassates slightly,and punctuate and sheet high signal can be fund in T1WI images in results of the increase of free water and Collagen break-up. Perfect MRI series is capable of showing the thickness, outline, shape and signal of cartilage well and truly。3D-FS-SPGR is now considered to be the best series showing cartilage of knee joints. My study also shows that,the measured thickness of knee joints cartilage is high to other series using 3D-FS-SPGR series. On the other side in this series glassy cartilage is of high signal and marrow is of low signal ,the contrast is very sharp .So the sensitivity and specificity are 81%,97%,veracity is 97% in 3D-FS-SPGR。The results of my study show that the sensitivity ,specificity ,veracity are 97.1%,97.8%,97.2% in 3D-FS-SPGR series.Conclusion:1. Routine series together with 3D-FS-SPGR of 1.5T MR scanner,can distinctly show the cartilage of knee joints,and is accordant with Arthroscope in value the number of cartilage trauma .2. 3D-FS-SPGR series is capable of showing knee joints cartilage more clearly .It can not only show the number of the damages but also has high accordance with Arthroscope in the classification of the damages ,thus to be the best series checking the trauma of knee joint cartilage. 3. The use of Arthroscope examination is limited because it has limitations such as hurt,low repeatability,can't discover inner damages of cartilage and early changes .On the other side MRI has fine tissue and spatial resolution,no hurt,display the shape and abnormal signals of cartilage clearly,and the repeatability is high,thus can be used in filtration and follow-up.In a word MRI is un-replaceable in evaluate the trauma of cartilage in knee joints,illustrates a good prospect of application and extension!...