Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA 02111, USA.
BMC Musculoskelet Disord. 2011 Sep 30;12:217. doi: 10.1186/1471-2474-12-217.
Bone marrow lesions (BMLs), common osteoarthritis-related magnetic resonance imaging findings, are associated with osteoarthritis progression and pain. However, there are no articles describing the use of 3-dimensional quantitative assessments to explore the longitudinal relationship between BMLs and hyaline cartilage loss. The purpose of this study was to assess the cross-sectional and longitudinal descriptive characteristics of BMLs with a simple measurement of approximate BML volume, and describe the cross-sectional and longitudinal relationships between BML size and the extent of hyaline cartilage damage.
107 participants with baseline and 24-month follow-up magnetic resonance images from a clinical trial were included with symptomatic knee osteoarthritis. An 'index' compartment was identified for each knee defined as the tibiofemoral compartment with greater disease severity. Subsequently, each knee was evaluated in four regions: index femur, index tibia, non-index femur, and non-index tibia. Approximate BML volume, the product of three linear measurements, was calculated for each BML within a region. Cartilage parameters in the index tibia and femur were measured based on manual segmentation.
BML volume changes by region were: index femur (median [95% confidence interval of the median]) 0.1 cm3 (-0.5 to 0.9 cm3), index tibia 0.5 cm3 (-0.3 to 1.7 cm3), non-index femur 0.4 cm3 (-0.2 to 1.6 cm3), and non-index tibia 0.2 cm3 (-0.1 to 1.2 cm3). Among 44 knees with full thickness cartilage loss, baseline tibia BML volume correlated with baseline tibia full thickness cartilage lesion area (r = 0.63, p< 0.002) and baseline femur BML volume with longitudinal change in femoral full thickness cartilage lesion area (r = 0.48 p< 0.002).
Many regions had no or small longitudinal changes in approximate BML volume but some knees experienced large changes. Baseline BML size was associated to longitudinal changes in area of full thickness cartilage loss.
骨髓病变（BMLs）是常见的与骨关节炎相关的磁共振成像表现，与骨关节炎的进展和疼痛有关。然而，目前尚无文章描述使用 3 维定量评估来探索 BML 与透明软骨丢失之间的纵向关系。本研究旨在通过简单测量近似 BML 体积来评估 BML 的横断面和纵向描述特征，并描述 BML 大小与透明软骨损伤程度之间的横断面和纵向关系。
纳入了一项临床试验的基线和 24 个月随访的磁共振图像，共 107 名有症状的膝骨关节炎患者。为每个膝关节确定了一个“索引”关节，定义为疾病严重程度较大的胫股关节。随后，每个膝关节在四个区域进行评估：索引股骨、索引胫骨、非索引股骨和非索引胫骨。每个区域内的每个 BML 计算三个线性测量值的乘积，得出近似 BML 体积。根据手动分割测量索引胫骨和股骨的软骨参数。
按区域划分，BML 体积的变化为：索引股骨（中位数[中位数的 95%置信区间]）0.1cm3（-0.5 至 0.9cm3），索引胫骨 0.5cm3（-0.3 至 1.7cm3），非索引股骨 0.4cm3（-0.2 至 1.6cm3），非索引胫骨 0.2cm3（-0.1 至 1.2cm3）。在 44 个全层软骨缺失的膝关节中，基线胫骨 BML 体积与基线胫骨全层软骨病变面积相关（r=0.63，p<0.002），基线股骨 BML 体积与股骨全层软骨病变面积的纵向变化相关（r=0.48，p<0.002）。
许多区域的近似 BML 体积没有或仅有较小的纵向变化，但有些膝关节的变化较大。基线 BML 大小与全层软骨缺失面积的纵向变化相关。
