Multiple Sequence Optimization Assessment Before MRI For Knee Osteoarthritis Joint Replacement

Part1:The diagnosis value of 3.0 T MR in knee joint osteoarthritis classificationObjectives(1)To study patients for X-ray and MRI with OA,by means of the classifywe can research OA patient’s cartilage injury at the inside of the room, outside room and patellofemoral articular in different periods, and provide the appropriate imaging examination method to the evaluation before the operation for severe patients.Methods(1)36 patients with OA between September 2013 to September 2013 in Ningxia People’s Hospital who did X-ray and sequence optimization of MRI.And all patients were under Philips DR and GE3.0 T MRI machine had be choesd.We get X ray film positive side of the image and multiple sequence MRI image.And the images will be analysed by the GE ADW4.5 workstation.Finally we will using SPSS 17.5 software for statistical analysis of the research object.Results(1) inside and outside the knee joint of X-ray and MRI classification results show that the lateral difference between joints and the inside of the joint have the statistical significance(P<0.05)and significant statistically significant(P<0.01)(2) Inside and outside knee OA patients and patellofemoral joint X-ray and MRI have significant statistical significance difference(P < 0.01)(3) Two kinds of classification method of OA in patients with medial joint are consistent with moderate(0.40<κ≤0.60); Poor uniformity of the lateral joint and patellar joint two grading method(κ≤0.40)Conclusion(1)X-rayregards highly as a classification diagnosis for severe patients.For o perating TKA surgery,we can make a preoperative assessment by means of X-ray inspection a nd clinical situations for the double disease osteoarthritis patient who want to save cost of trea tment.(2)In the clinical,we always suggest further lines of MRI, when making a classification evaluation for OA patient whose X-ray shows not particularly severe,at least one side compartment degeneration.Not only it can display the cruciate ligament function, but also further to observe and evaluate the lateral joint patellofemoral articular cartilage. Part2: 3.0 T MRI quantitative techniques for knee osteoarthritis assessment before the replacementObjectives(1)Investigate the knee joint cartilage’s range of normal volunteers’ T2 * value,Slow ADC value,and Fast ADC value in the normal volunteers.(2)Investigate the differences of T2 * value,Slow ADC value,Fast ADC value between the mild OA group,severe OA group and normal volunteer group.(3)Investigate the knees inside and outside of severe OA patients and provide quantitative basis for the choice of the ways of knee surgery.(4)Through comparing with multiple scanning sequence MR classification and pathological classification,we will make a guidance knee replacement option.Methods Regard totals of 36 OA patients in the first part as the case group. Classify grades according to the MRI Retch classification standard:Ⅰ, Ⅱis the mild groups and Ⅲ, Ⅳis the severe groups.Choose healthy volunteers 27 cases as control group.With the processed images,we can measure cartilage of T2*value,Slow ADC value and Fast ADC value.Select each 4 articular cartilages from 17 knee replacement surgery patients,7 UAK surgery patients and10 TKA surgery patients in OA patients to get 60 samples.Results(1) Healthy volunteers knee joint cartilage T2 * value difference between groups have significant statistical significance(P < 0.01); Slow ADC value, Fast ADC no statistically significant difference(P > 0.05).(2) Mild OA of the knee of the upper lateral cartilage group, the severe OA group T2 * value between the outside and the control group, Slow ADC value, Fast ADC were statistically significant differences(P < 0.01); Mild OA of the knee medial cartilage group, the severe OA group T2 * value between the outside and the control group, Slow ADC values are statistically significant differences(P < 0.01), Fast ADC value no statistical difference(P > 0.05); Mild OA of patella cartilage, severe OA group T2 * value between the outside and the control group, Slow ADC values are statistically significant differences(P < 0.01); Fast ADC value no statistical difference(P > 0.05).(3) In knee OA patients, significant statistically significant T2 * values of the upper lateral cartilage(< 0.01). Slow ADC value, Fast ADC no statistical difference(P>0.05).Conclusion(1) T2*mapping imaging and e DWI imaging can distinguish the lesions from different periods of OA. The T2* and Slow ADC values can be found in early OA lesions.(2) merge sequence combined with conventional MR imaging sequence of OA classification has a high diagnostic accuracy, in front of the arthroplasty can observe articular cartilage injury by merge combined with conventional sequences, T2*mapping imaging diagnostic value than merge sequences and provide soft bone quantitative indexes for replacement.