同种异体骨软骨移植手术前后影像学评估

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摘要软骨损伤是一种常见病、多发病，常会导致以软骨退变、软骨下骨囊变、增生硬化、骨赘形成及关节内炎症为特点的骨关节炎，严重者导致关节功能丧失，故软骨组织缺损早期修复治疗迫切而意义重大。治疗软骨损伤的方法可分为姑息性治疗、修复治疗和恢复性治疗。姑息性治疗包括软骨清创和软骨成形术；修复和恢复性治疗包括骨髓刺激技术、自体软骨细胞移植(autologous chondrocyte implantation，ACI)、自体骨软骨移植和同种异体骨软骨移植(osteochondral allograft transplantation，OCA)。其中OCA是治疗局限性大块关节软骨损伤的有效手段。OCA可以提供与损伤部位相同曲度的关节面，具有不受供区取材限制、骨融合率高及临床结果可靠等优势，可以弥补其他方法存在的不能形成透明软骨、修复组织远期退变等不足。
X线及电子计算机断层扫描(computed tomography，CT)等影像学检查可以评估OCA移植前后病区变化，但在术前评估、动态监测和观察OCA移植后软骨修复情况方面存在一定不足。磁共振成像(magnetic resonance imaging，MRI)可弥补X线和CT检查存在的不足，对其进行非侵入动态可视化研究和评估，实现术前软骨损伤尺寸的测量。本综述重点介绍利用MRI观察评分系统及定量序列动态监测移植物信号强度、缺损填充程度、移植物界面愈合程度和软骨下骨退变程度等各项指标，进而对OCA术后移植成功与否进行全面评估。

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	齐美玲
	刘振宇
	甄俊平

基金资助:国家自然科学基金项目(82172011)
山西自然科学基金项目(202203021221275)

通讯作者: 甄俊平

作者简介: 齐美玲(1998－ )，女，研究生在读，山西医科大学第二医院影像科，qimeiling0612@163.com

引用本文:

齐美玲，刘振宇，甄俊平. 同种异体骨软骨移植手术前后影像学评估[J]. 实用骨科杂志, 2024, 30(5): 390-.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2024/V30/I5/390

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