RISS 검색 - 국내학술지논문 상세보기

다국어 초록 (Multilingual Abstract)

Background : Synovium is a main target of rheumatoid arthritis. Synovial changes, however, have been overlooked in degenerative osteoarthritis (OA). In intraarticular tissues, especially cartilage, pain conducting fibers or vasculatures are normally absent, therefore, periarticular soft tissue changes, such as synovial pathology may be an important clue to understand the progression of OA. In addition. MRI was established as an excellent modality to characterize the articular changes of OA. However, synovial changes detected by MRI have not been evaluated based on histopathologic features of synovium.
Methods and Materials : Total twenty six patients (male 11, female 15) of OA involving knee joint were collected in Kupo Sumgsim Hospital. MRI features of 24 cases were reviewed and its severity including synovial thickening and joint effusion were graded as 3 groups. Through arthroscopic examination, synovial biopsy was performed. Histologic features of the synovium, emphasizing on the synovial cell hyperplasia, inflammatory cell infiltration, fibrosis and vascularity were evalutated in accordance with MRI severity.
Results : 1) Considrable MRI changes, joint effusion, and synovial hypertrophy (≥2mm) were noted in 12 cases (50.0%), 16 cases (66.7%), and 20 cases (83.3%) respectively. In 12 of 13 Gd-DTPA contrast studies, T1 enhanced image was achieved, and irregular or villous pattern was noted in 8 cases (40.0%) of 20 hypertrophied synovium. 2) Synovial cell hyperplasia (>2 cells in layer) was noted in 9 cases (34.6%) and lymphocytic infiltration (with minimal or mild degree) was noted in 11 cases (42.3%). Microvessel density was variable from case to case (MVD=12.4±2.7, Nikon Labophot, area=0.73 mm2, x200) and pattern of collagen deposition (loose or dense) was in equal proportion. 3) Although MRI changes and synovial hypertrophy were not correlated with various histopathologic changes, such as synovial cell hyperplasia, lymphocytic infiltration, collagen deposition and vascular proliferation, joint effusion was significantly correlated with TGF-α expression of synovial cells, collagen deposition and microvessel density. 4) Degree of MRI was more severe in female than male, in old than young age group, and in long duration (>1 year).
Conclusion : Synovial hypertrophy detected by MRI is not correlated with histopathologic changes of synovium in knee OA. Both synovial effusion and hypertrophy, however, are correlated with vascular proliferation in some degree, which is remained to be clarified in more accumulated cases.

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목차 (Table of Contents)

서론
재료 및 방법
1. 환자의 선정
2. MRI 검사
3. 관절내시경 검사 및 활액막의 채취

서론
재료 및 방법
1. 환자의 선정
2. MRI 검사
3. 관절내시경 검사 및 활액막의 채취
4. 광학현미경적 및 면역조직화학적 검사
5. 통계처리
결 과
1. 임상 소견
2. 방사선학적 소견
3. 광학현미경적 및 면역조직화학적 소견
4. 방사선학적 소견과 임상적 소견
5. 병리학적 소견과 방사선학적 소견
고찰
결론
참고문헌

참고문헌 (Reference)

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