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EARLY DIAGNOSIS OF GROWTH DISORDERS USING MR IMAGING

使用 MR 成像对生长障碍进行早期诊断

基本信息

批准号：
2732854
负责人：
DIEGO JARAMILLO
金额：
$ 10.45万
依托单位：
BOSTON CHILDREN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
1994
资助国家：
美国
起止时间：
1994-07-15 至 2000-06-30
项目状态：
已结题

项目摘要

Specialized cartilaginous structures at the ends of bones, the epiphysis and growth plate (physis), are the site of normal bone growth in children. Limb deformity results from damage to this growth cartilage. Prompt treatment of epiphyseal and physeal injuries can prevent or minimize abnormal bone growth. Because damage to the growth cartilage is not directly detectable radiographically, growth disturbances are discovered only months after injury, when bony abnormalities develop. The hypothesis to be evaluated is that Magnetic Resonance (MR) allows earlier and more accurate evaluation of growth disorders by showing alterations in the composition and vascularity of the growth cartilage. A corollary is that the likelihood of growth disturbance can be predicted by analyzing the pattern of injury to the growth cartilage. First, MR characteristics of the normal anatomy and development of the cartilaginous epiphysis and physis (including signal characteristics, and measurements of T2 relaxation times) will be correlated with histochemistry. The cartilaginous abnormalities due to direct injury to the physis will be studied in two animal models to test the following hypothesis: a) In transverse fractures, extension of the fracture to the epiphyseal side of the physis is detectable by MR and greatly increases the likelihood of growth arrest; b) In vertical fractures, development of a transphyseal vascularity and disorganization of the cartilage results in growth arrest. Abnormalities due to indirect injury to the growth cartilage will be studied in an animal model of epiphyseal ischemia to determine whether abnormal blood flow in the vascular channels of the unossified epiphysis (detectable by contrast- enhanced MR) results in ischemic damage to the epiphyseal and physeal cartilage and eventually in abnormal ossification. A cohort study of children with physeal fractures will be performed to evaluate the role of MR imaging in predicting bony bridge formation based on the early evidence of damage to the physeal cartilage. The ultimate goals of this research are; a) to develop methods of early detection of damage to the growth cartilage which will allow earlier therapy and prevention of deformity, b) to gain a better understanding of skeletal growth disturbances by seeing the evolution of cartilaginous injury in vivo, and c) to validate models which may serve for future research on new therapies for growth arrest.

位于骨端的特化软骨结构，骨骺和生长板(生长板)，是儿童正常骨骼生长的部位。肢体畸形是由于这种生长的软骨受损造成的。提示骨骺和骨痂损伤的治疗可以预防或尽量减少骨骼生长异常。因为对生长软骨的损伤不是可通过射线照相直接检测的生长障碍被发现只有在受伤几个月后，才会出现骨骼异常。假说要评估的是磁共振(MR)允许更早和更多通过显示生长发育障碍的改变来准确评估生长障碍生长软骨的成分和血管。推论就是通过分析生长障碍的可能性，可以预测生长软骨的损伤类型。第一，MR的特点软骨骺和软骨的正常解剖与发育 Physis(包括信号特征和T2弛豫测量时间)将与组织化学相关联。软骨性直接损伤骨赘造成的异常将分两部分进行研究。用动物模型检验以下假设：a)在横向骨折，将骨折延伸至骨赘侧是可以被MR发现的，并大大增加了增长停滞的可能性； B)在垂直骨折中，经椎弓根血管的发展和软骨的解体会导致生长停滞。异常由于对生长软骨的间接损伤，将在动物身上进行研究建立骨骺缺血模型，判断是否存在异常血流。未骨化骨痂的血管通道(通过对比可以检测到- MR增强)导致骨骺和生长板的缺血性损伤软骨最终会发生异常骨化。一项队列研究将对骨赘骨折的儿童进行检查，以评估其作用。基于早期证据的磁共振成像预测骨桥形成生长板软骨的损伤。这项研究的最终目标是 A)开发早期检测生长损害的方法软骨，这将使早期治疗和预防畸形，b) 通过观察来更好地了解骨骼生长障碍体内软骨损伤的演变，以及c)验证模型这可能为未来针对生长停滞的新疗法的研究提供服务。