Kijowski Richard, Stanton Paul, Fine Jason, De Smet Arthur
Department of Radiology, University of Wisconsin Hospital, Clinical Science Center-E3/311, Madison, WI 53792-3252, USA.
Radiology. 2006 Mar;238(3):943-9. doi: 10.1148/radiol.2382050122. Epub 2006 Jan 19.
To retrospectively determine at magnetic resonance (MR) imaging the prevalence of subchondral bone marrow edema beneath arthroscopically proved articular cartilage defects.
The study was performed in compliance with HIPAA regulations, and a waiver of informed consent was obtained from the institutional review board before the study was performed. The study consisted of 132 patients (70 men, 62 women; average age, 53 years) with articular cartilage defects of the knee joint who underwent MR imaging of the knee and subsequent arthroscopic knee surgery. At the time of arthroscopy, each articular cartilage lesion was graded by using the Noyes classification system. MR examinations were retrospectively reviewed to determine the size, depth, and location of subchondral bone marrow edema without knowledge of the arthroscopic findings. Pairwise Fisher exact tests and two-sample t tests were used to correlate MR imaging findings of subchondral bone marrow edema with the arthroscopic grade of articular cartilage degeneration.
Subchondral bone marrow edema was seen beneath 105 (19%) of 554 articular cartilage defects identified at arthroscopy. It was not observed beneath any of the six grade 1 cartilage defects but was observed beneath eight (4.9%) of 163 grade 2A defects, 40 (14.4%) of 278 grade 2B defects, 54 (55.1%) of 98 grade 3A defects, and three (33.3%) of nine grade 3B defects. Subchondral bone marrow edema was also seen beneath four (1.4%) of 238 articular surfaces that appeared normal at arthroscopy. The mean depth and cross-sectional area of subchondral bone marrow edema increased with increasing grade of the articular cartilage lesion.
Higher grades of articular cartilage defects are associated with higher prevalence and greater depth and cross-sectional area of subchondral bone marrow edema.
通过磁共振成像（MR）回顾性确定关节镜证实的关节软骨缺损下方软骨下骨髓水肿的患病率。
本研究按照健康保险流通与责任法案（HIPAA）的规定进行，在研究开展前获得了机构审查委员会的知情同意豁免。该研究纳入了132例膝关节软骨缺损患者（70例男性，62例女性；平均年龄53岁），这些患者均接受了膝关节MR成像检查及随后的膝关节镜手术。在关节镜检查时，使用诺伊斯分类系统对每个关节软骨损伤进行分级。在不知晓关节镜检查结果的情况下，对MR检查进行回顾性分析，以确定软骨下骨髓水肿的大小、深度和位置。采用配对费舍尔精确检验和两样本t检验，将软骨下骨髓水肿的MR成像表现与关节软骨退变的关节镜分级进行关联分析。
在关节镜检查发现的554处关节软骨缺损中，有105处（19%）下方可见软骨下骨髓水肿。在6处1级软骨缺损中均未观察到，但在163处2A级缺损中有8处（4.9%）、278处2B级缺损中有40处（14.4%）、98处3A级缺损中有54处（55.1%）以及9处3B级缺损中有3处（33.3%）下方观察到。在关节镜检查时看似正常的238个关节表面中，有4处（1.4%）下方也可见软骨下骨髓水肿。软骨下骨髓水肿的平均深度和横截面积随着关节软骨损伤分级的增加而增大。
较高等级的关节软骨缺损与软骨下骨髓水肿的较高患病率、更大深度和横截面积相关。
