Quantitative Imaging Center, Department of Radiology, and Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, MA 02118, USA.
Radiology. 2010 Sep;256(3):855-62. doi: 10.1148/radiol.10091467. Epub 2010 Jun 8.
To assess the association of prevalent bone marrow edema-like lesions (BMLs) and full-thickness cartilage loss with incident subchondral cyst-like lesions (SCs) in the knee to evaluate the bone contusion versus synovial fluid intrusion theories of SC formation.
The Multicenter Osteoarthritis study is a longitudinal study of individuals who have or are at risk for knee osteoarthritis. The HIPAA-compliant protocol was approved by the institutional review boards of all participating centers, and written informed consent was obtained from all participants. Magnetic resonance images were acquired at baseline and 30-month follow-up and read semiquantitatively by using the Whole-Organ Magnetic Resonance Imaging Score system. The tibiofemoral and patellofemoral joints were subdivided into 14 subregions. BMLs and SCs were scored from 0 to 3. Cartilage morphology was scored from 0 to 6. The association of prevalent BMLs and full-thickness cartilage loss with incident SCs in the same subregion was assessed by using logistic regression with mutual adjustment for both predictors.
A total of 1283 knees were included. After adjustment for full-thickness cartilage loss, prevalent BMLs showed a strong and significant association with incident SCs in the same subregion, with an odds ratio of 12.9 (95% confidence interval [CI]: 8.9, 18.6). After adjustment for BMLs, prevalent full-thickness cartilage loss showed a significant but much less important association with incident SCs in the same subregion (odds ratio, 1.4; 95% CI: 1.0, 2.0). There was no apparent relationship between severity of full-thickness cartilage loss at baseline and incident SCs.
Prevalent BMLs strongly predict incident SCs in the same subregion, even after adjustment for full-thickness cartilage loss, which supports the bone contusion theory of SC formation.
评估膝关节骨髓水肿样病变（BML）和全层软骨缺失与骨下囊样病变（SCs）的相关性，以评估 SC 形成的骨挫伤与滑膜液渗透理论。
多中心骨关节炎研究是一项针对膝关节骨关节炎患者或高危人群的纵向研究。该 HIPAA 合规协议已获得所有参与中心的机构审查委员会批准，并获得所有参与者的书面知情同意。在基线和 30 个月随访时采集磁共振图像，并使用全器官磁共振成像评分系统进行半定量阅读。胫股和髌股关节分为 14 个亚区。BML 和 SC 评分范围为 0-3 分。软骨形态评分范围为 0-6 分。采用逻辑回归相互调整两个预测因子，评估同一亚区中现患 BML 和全层软骨缺失与新发病变 SC 之间的相关性。
共纳入 1283 个膝关节。在调整全层软骨缺失后，现患 BML 与同一亚区的新发病变 SC 之间存在强烈且显著的相关性，比值比为 12.9（95%置信区间 [CI]：8.9，18.6）。在调整 BML 后，现患全层软骨缺失与同一亚区的新发病变 SC 之间存在显著但重要性较小的相关性（比值比，1.4；95%CI：1.0，2.0）。基线时全层软骨缺失的严重程度与新发病变 SC 之间无明显关系。
即使在调整全层软骨缺失后，现患 BML 也能强烈预测同一亚区的新发病变 SC，这支持了 SC 形成的骨挫伤理论。
