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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >QUANTITATIVE ANALYSIS OF THE VASCULARITY OF SKELETALLY IMMATURE FEMORAL CONDYLES: A CADAVER STUDY USING CONTRAST-ENHANCED MAGNETIC RESONANCE IMAGING
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QUANTITATIVE ANALYSIS OF THE VASCULARITY OF SKELETALLY IMMATURE FEMORAL CONDYLES: A CADAVER STUDY USING CONTRAST-ENHANCED MAGNETIC RESONANCE IMAGING

机译：骨骼发育不良的股骨突的血管性的定量分析：利用对比增强磁共振成像的CADAVER研究

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Background: The arterial supply to the chondroepiphysis is of paramount importance for proper nutrition and development. Previous animal studies had demonstrated that ischemic necrosis of the chondroepiphysis plays an important role in subsequent development of osteochondritis dissecans (OCD). Previous studies using susceptibility weighted imaging, a magnetic resonance image (MRI) sequence, demonstrated a pattern of disappearance of the arterial system over time at predilection sites for OCD lesions. The purposed of this study is to quantify distribution of the arterial perfusion in different zones of the immature distal femoral chondroepiphysis. Methods: We utilized 5 fresh frozen skeletally immature human cadaver knees (aged 0-6 months). The superficial femoral artery was cannulated proximal to the knee joint and major arteries distal to the knee joint were tied off. For volumetric analysis, comparisons were performed between contrast-enhanced and pre-contrast MRI. Regions of interest were developed to quantify the contrast enhancement in different zones of the chondroepiphysis, excluding the secondary ossification center. (Fig.1) Results: Quantitative MRI analysis demonstrated equivalent enhancement within the medial and lateral condyles in the 5 month and one of the 2 month specimens. The 0 month and 6 month specimens demonstrated greater enhancement in the medial condyle. One of the 2 months specimen demonstrated greater perfusion in the lateral condyle. The distal condyle analysis demonstrated equivalent enhancement in the 0 month, one of the 2 months and the 6 months specimens. The 5 month specimen demonstrated greater enhancement in the lateral distal condyle. The other 2 months specimen demonstrated greater enhancement in the medial distal condyle. The posterior condyle analysis demonstrated greater enhancement in the posterior lateral condyle in one of the 2 month specimen, and the 5 month and the 6 month specimens. The 0 month specimen demonstrated greater enhancement in the medial side. The other 2 month specimen demonstrated equivalent enhancement between medial and lateral side. Analyzing the medial condyle revealed equivalent enhancement in the medial and lateral zone in the 5 month and 6 month specimens. The 0 month specimen demonstrated greater enhancement laterally. Both 2 months specimens demonstrated greater enhancement in the medial side. Conclusion: This study expands the knowledge on the vascularity of the developing distal femoral chondroepiphysis, which may have an impact on our future understanding of OCD etiology, physeal growth, and peri-articular infections. The majority of the specimens demonstrated diminished perfusion in the posterior aspect of the medial femoral condyle when compare to the lateral posterior condyle. This is where the predilected area for the development of OCD lesions is located. Future studies in human and other mammals susceptible to knee OCD, along with the ongoing development of animal models of OCD will benefit from this information.
机译：背景：软骨软骨的动脉供应对于适当的营养和发育至关重要。先前的动物研究表明，软骨表皮的缺血性坏死在解剖性骨软骨炎（OCD）的后续发展中起着重要作用。以前使用磁化加权成像，磁共振图像（MRI）序列的研究表明，随着时间的推移，OCD病变的好发部位动脉系统消失了。这项研究的目的是量化未成熟的股骨远端软骨垂体不同区域的动脉灌注分布。方法：我们使用了5个新鲜的冷冻骨骼未成熟的人尸体膝盖（年龄0-6个月）。股浅动脉在膝关节近侧插管，而膝关节远侧的大动脉被打结。对于体积分析，在对比增强MRI和对比增强MRI之间进行了比较。开发了感兴趣的区域，以量化软骨骨e的不同区域（次生骨化中心除外）中对比度的增强。 （图1）结果：MRI定量分析显示，在5个月和2个月的一个样本中，内侧和外侧con内的增强相同。 0个月和6个月的标本显示内侧con的增强更大。 2个月的标本之一显示出外侧greater的灌注更大。远端con分析显示在0个月，2个月和6个月的样本中有一个等价的增强。 5个月的标本显示外侧distal远端更大的增强。其他2个月的样本显示内侧distal远端更大的增强。后con分析显示2个月标本之一，5个月和6个月标本之一的后外侧lateral突有更大增强。 0个月的标本显示内侧有更大的增强。另外两个月的样本显示内侧和外侧之间的等效增强。分析内侧con，发现在5个月和6个月的样本中，内侧和外侧区域的增强程度相同。 0个月的标本在侧面表现出更大的增强。两个月的两个标本均显示内侧有更大的增强。结论：这项研究扩大了对发展中的股骨远端软骨垂体的血管性的认识，这可能会影响我们对OCD病因，脉管生长和关节周围感染的未来理解。与外侧后con相比，大多数标本显示内侧the的后方灌注减少。这是OCD病变发展的首选区域。将来，有关人类和其他容易患膝盖OCD的哺乳动物的研究以及正在开发的OCD动物模型将受益于此信息。

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