[原著］実験的脊椎椎体問骨移植の骨癒合過程 : MRIおよび組織所見の比較

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概要

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• The purpose of this study is to evaluate the bone union process of a grafted bone using magnetic resonance imaging.(MRI). Two similar iliac bone blocks (2cmaX3cm in size) were removed from bilateral rabbit iliums. Each block was replaced with the other as a grafted bone. The MRI and specimens of the grafted bone were obtained periodically after surgery. MRI findings:At 2 weeks after surgery, low intensity area (LIA) appeared at the junction of the grafted bone and recipient ilium, on T1 weighted image (T1WI) and fat image. The grafted bone was enhanced at the junction on Gd-DTPA enhanced TIWI (Gd-Tl) and Gd-DTPA enhanced fat suppression image (Gd-FS). At 4 weeks, LIA on T1Wl and fat image had enlarged into the whole area of the grafted bone. The grafted bone had been entirely enhanced on Gd-T1 and Gd-FS. The enhanced area on Gd-T1 and Gd-FS coincided with LIA on T1WI and fat image. At 9 weeks, LIA on T1WI and fat image had been recovering gradually. Enhanced effects on Gd-Tl and Gd-FS had been diminishing. At 15 weeks, LIA on T1WI and fat images had obtained isointensity, and enhanced effects on Gd-T1 and Gd-FS had vanished completey. Histological findings:At 2 weeks after surgery, vascular rich connective tissue extended into the intertrabecular space of the grafted bone from the junction. The hematopoietic marrow had been replaced with connective tissue and inflammatory cells Bone resorption and appositional new bone formations were seen at the junctional area. At 4 weeks, bony continuity and extensive bony callus formation along the surface were observed at the juncition. The hematopoietic marrow had been entirely replaced with vascular rich connective tissue. Appositional new bone formations extended to trabecula area. At 9 weeks, the connective tissue diminished and was replaced with hematopoietic marrow in some areas. At 15 weeks, the connective tissue had vanished with complete recovery of hematopoietic marrow. The comparison between the MRl and the histological findings of the grafted bone indicated that sequential chages of LIA on T1WI and fat image mainly depended on the change of fat volume, and that sequential changes of enhanced effect on Gd-T1 and Gd-FS mainly represented extension or withdrawal of the vascular rich connetive tissue. This experimental study suggests that bone union process and nonunion can evaluated using MRI.

• 琉球医学会,Ryukyu Medical Associationの論文

著者

• 棚原 豊

  大浜第一病院整形外科

• 佐藤 栄

  富永草野病院整形外科

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