Experimental assessment by high frequency ultrasound of articular cartilage thickness and osteoarthritic changes.
Experimental assessment by high frequency ultrasound of articular cartilage thickness and osteoarthritic changes.
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发表时间：
1995
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通讯作者：
S. Myers;K. Dines;Brandt Da;K. Brandt;M. Albrecht
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作者：
S. Myers;K. Dines;Brandt Da;K. Brandt;M. Albrecht
目的骨关节炎（OA）是一种以关节软骨进行性丢失为特征的疾病。然而，在体内精确地、可重复地测量软骨的厚度是困难的。由于开发用于关节内的超声成像设备是可行的，并且可以获得可以补充关节镜下关节软骨评估的信息，因此我们评估了高频超声在评估正常和OA软骨厚度和表面下特征方面的有效性。方法用25 MHz脉冲回波超声扫描仪对人股骨软骨和软骨下骨块以及单独的软骨碎片进行了体外检查，该扫描仪将软骨的横截面描绘为B型图像。关节面的大体和组织学外观用于识别无瑕疵、正常软骨和OA软骨样本。软骨中的声速，从软骨厚度和声音传输的测量确定，与其生化成分。结果正常软骨中的声速（1658 ± 185 m/s，n = 27）大于OA软骨中的声速（1581 ± 148 m/s，n = 40，p = 0.06），但与软骨含水量、糖醛酸或羟脯氨酸浓度无关。正常软骨的图像显示在组织表面具有低回声基质的平滑回声带;在纤维化软骨的扫描中，该带的宽度与纤维化的深度成比例（r = 0.78）。OA软骨厚度的超声和组织学测量密切相关（r = 0.87），重复测量的平均变异系数为2%。结论体外高频超声图像可以准确、重复地测量正常和OA关节软骨的厚度和亚表面特征。
OBJECTIVE Osteoarthritis (OA) is characterized by progressive loss of articular cartilage in the involved joint. Accurate, reproducible measurement of the thickness of the cartilage in vivo, however, is difficult. Because development of an ultrasonic imaging device for intraarticular use is feasible and would permit acquisition of information that could complement the assessment of articular cartilage made at arthroscopy, we evaluated the efficacy of high frequency ultrasound in assessing the thickness and subsurface characteristics of normal and OA cartilage. METHODS Blocks of human femoral cartilage and subchondral bone and chips of cartilage alone were examined in vitro with an experimental 25 MHz pulse-echo ultrasound scanner that portrayed cross sections of the cartilage as B-mode images. The gross and histologic appearance of the articular surface was used to identify specimens of unblemished, normal cartilage and OA cartilage. The speed of sound in cartilage, determined from measurements of cartilage thickness and sound transmission, was related to its biochemical composition. RESULTS The speed of sound in normal cartilage (1658 +/- 185 m/s, n = 27) was greater than that in OA cartilage (1581 +/- 148 m/s, n = 40, p = 0.06), but was not related to the cartilage water content or the concentration of uronic acid or hydroxyproline. Images of normal cartilage showed a smooth echo band at the tissue surface with a hypoechoic matrix; in scans of fibrillated cartilage the width of this band was proportional to the depth of fibrillation (r = 0.78). Ultrasonic and histologic measurements of OA cartilage thickness were closely correlated (r = 0.87) and the mean coefficient of variation for repeated measurements was 2%. CONCLUSION High frequency ultrasonic images obtained in vitro provide highly accurate and reproducible measurements of the thickness and subsurface characteristics of normal and OA articular cartilage.