专门的 1.0T 肢体 MRI 与大孔径 1.5T MRI 对半定量评估骨关节炎的比较：MOST 研究。
A comparison of dedicated 1.0 T extremity MRI vs large-bore 1.5 T MRI for semiquantitative whole organ assessment of osteoarthritis: the MOST study.
机构信息
Quantitative Imaging Center (QIC), Department of Radiology, Boston University Medical Center, Boston, MA 02118, USA.
出版信息
Osteoarthritis Cartilage. 2010 Feb;18(2):168-74. doi: 10.1016/j.joca.2009.08.017. Epub 2009 Sep 9.
OBJECTIVE
To date semiquantitative whole-organ scoring of knee osteoarthritis (OA) relies on 1.5 Tesla (T) Magnetic resonance imaging (MRI) systems. Less costly 1.0 T extremity systems have been introduced that offer superior patient comfort, but may have limitations concerning field-of-view and image quality. The aim of this study was to compare semi-quantitative (SQ) scoring on a 1.0 T system using 1.5 T MRI as the standard of reference.
METHODS
The Multicenter Osteoarthritis Study (MOST) is a longitudinal study of individuals who have or are at high risk for knee OA. A sample of 53 knees was selected in which MRI was performed on a 1.0 T extremity system as well as on a 1.5 T scanner applying a comparable sequence protocol. MRIs were read according to the Whole Organ Magnetic Resonance Imaging Score (WORMS) score. Agreement was determined using weighted kappa statistics. Sensitivity, specificity and accuracy were assessed using the 1.5 T readings as the reference standard. In addition the number of non-readable features was assessed.
RESULTS
Agreement (w-kappa) for seven main WORMS features (cartilage, bone marrow lesions (BMLs), osteophytes, meniscal damage and extrusion, synovitis, effusion) ranged between 0.54 (synovitis) and 0.75 (cartilage). Sensitivity ranged between 68.1% (meniscal damage) and 88.1% (effusion). Specificity ranged between 63.6% (effusion) and 96.4% (BMLs). Although the overall rate of non-readable features was very low, it was higher for the 1.0 T system (1.9% vs 0.2%).
CONCLUSIONS
Semiquantitative whole organ scoring can be performed using a 1.0 T peripheral scanner with a moderate to high degree of agreement and accuracy compared to SQ assessment using a 1.5 T whole body scanner. Our results are comparable to the published inter- and intra observer exercises obtained from 1.5 T systems. Sensitivity to change of longitudinal scoring was not evaluated in this cross-sectional design and should be investigated in future validation studies.
目的
目前膝关节骨关节炎（OA）的半定量整体评分依赖于 1.5T 磁共振成像（MRI）系统。已经引入了成本较低的 1.0T 肢体系统，该系统为患者提供了更好的舒适度，但在视野和图像质量方面可能存在局限性。本研究的目的是比较使用 1.0T 系统进行半定量（SQ）评分，并将 1.5T MRI 作为参考标准。
方法
多中心骨关节炎研究（MOST）是一项针对已患有或有膝关节 OA 高风险人群的纵向研究。选择了 53 例膝关节进行 MRI 检查，这些膝关节分别在 1.0T 肢体系统和 1.5T 扫描仪上进行，应用了相似的序列方案。MRI 根据全器官磁共振成像评分（WORMS）评分进行阅读。采用加权 kappa 统计来确定一致性。使用 1.5T 读数作为参考标准，评估敏感性、特异性和准确性。此外，还评估了不可读特征的数量。
结果
七种主要 WORMS 特征（软骨、骨髓病变（BML）、骨赘、半月板损伤和挤出、滑膜炎、积液）的一致性（加权 kappa）范围为 0.54（滑膜炎）至 0.75（软骨）。敏感性范围为 68.1%（半月板损伤）至 88.1%（积液）。特异性范围为 63.6%（积液）至 96.4%（BML）。虽然不可读特征的总体发生率非常低，但在 1.0T 系统中更高（1.9%比 0.2%）。
结论
与使用 1.5T 全身扫描仪进行 SQ 评估相比，使用 1.0T 外周扫描仪可以以中等至高度的一致性和准确性进行半定量全器官评分。我们的结果与从 1.5T 系统获得的已发表的观察者间和观察者内练习相当。在这种横断面设计中，未评估纵向评分的变化敏感性，应在未来的验证研究中进行调查。
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