Chu Constance R, Williams Ashley, Tolliver David, Kwoh C Kent, Bruno Stephen, Irrgang James J
Cartilage Restoration Center, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
Arthritis Rheum. 2010 May;62(5):1412-20. doi: 10.1002/art.27378.
OBJECTIVE: Quantitative and nondestructive methods for clinical diagnosis and staging of articular cartilage degeneration are important to the evaluation of potential disease-modifying treatments in osteoarthritis (OA). Optical coherence tomography (OCT) is a novel imaging technology that can generate microscopic-resolution cross-sectional images of articular cartilage in near real-time. This study tested the hypotheses that OCT can be used clinically to identify early cartilage degeneration and that OCT findings correlate with magnetic resonance imaging (MRI) T2 values and arthroscopy results. METHODS: Patients undergoing arthroscopy for degenerative meniscal tears were recruited under Institutional Review Board-approved protocols. Thirty consecutive subjects completing preoperative 3.0T MRI, arthroscopy, and intraoperative OCT comprised the study group. Qualitative and quantitative OCT results and MRI T2 values were compared with modified Outerbridge cartilage degeneration scores (0-4 scale) assigned at arthroscopy. RESULTS: Arthroscopic grades showed cartilage abnormality in 23 of the 30 patients. OCT grades were abnormal in 28 of the 30 patients. Both qualitative and quantitative OCT strongly correlated with the arthroscopy results (P = 0.004 and P = 0.0002, respectively, by Kruskal-Wallis test). Neither the superficial nor the deep cartilage T2 values correlated with the arthroscopy results. The quantitative OCT results correlated with the T2 values in the superficial cartilage (Pearson's r = 0.39, P = 0.03). CONCLUSION: These data show that OCT can be used clinically to provide qualitative and quantitative assessments of early articular cartilage degeneration that strongly correlate with arthroscopy results. The correlation between the quantitative OCT values and T2 values for the superficial cartilage further supports the utility of OCT as a clinical research tool, providing quantifiable microscopic resolution data on the articular cartilage structure. New technologies for nondestructive quantitative assessment of human articular cartilage degeneration may facilitate the development of strategies to delay or prevent the onset of OA.
目的：用于关节软骨退变临床诊断和分期的定量及非破坏性方法对于评估骨关节炎（OA）潜在的疾病改善治疗至关重要。光学相干断层扫描（OCT）是一种新型成像技术，能够近乎实时地生成关节软骨的微观分辨率横断面图像。本研究检验了以下假设：OCT可在临床上用于识别早期软骨退变，且OCT结果与磁共振成像（MRI）T2值及关节镜检查结果相关。 方法：根据机构审查委员会批准的方案招募因退行性半月板撕裂接受关节镜检查的患者。连续30名完成术前3.0T MRI、关节镜检查及术中OCT的受试者组成研究组。将定性和定量OCT结果及MRI T2值与关节镜检查时指定的改良Outerbridge软骨退变评分（0 - 4级）进行比较。 结果：关节镜分级显示30例患者中有23例存在软骨异常。OCT分级显示30例患者中有28例异常。定性和定量OCT均与关节镜检查结果密切相关（分别通过Kruskal - Wallis检验，P = 0.004和P = 0.0002）。浅层和深层软骨T2值均与关节镜检查结果无关。定量OCT结果与浅层软骨的T2值相关（Pearson相关系数r = 0.39，P = 0.03）。 结论：这些数据表明，OCT可在临床上用于对早期关节软骨退变进行定性和定量评估，且与关节镜检查结果密切相关。定量OCT值与浅层软骨T2值之间的相关性进一步支持了OCT作为临床研究工具的实用性，可提供关于关节软骨结构的可量化微观分辨率数据。用于人类关节软骨退变非破坏性定量评估的新技术可能有助于制定延缓或预防OA发病的策略。
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