Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA.
Osteoarthritis Cartilage. 2012 Dec;20(12):1519-26. doi: 10.1016/j.joca.2012.08.013. Epub 2012 Aug 30.
Bone marrow lesions (BMLs) are a common magnetic resonance (MR) feature in patients with osteoarthritis, however their pathological basis remains poorly understood and has not been evaluated in vivo. Our aim was to evaluate the trabecular structure associated with the presence and size of BMLs present in the same regions of interest (ROI) using quantitative MR-based trabecular morphometry.
158 participants in the Osteoarthritis Initiative (OAI) were imaged with a coronal 3D fast imaging with steady state precession (FISP) sequence for trabecular morphometry in the same session as the OAI 3 T MR knee evaluation. The proximal medial tibial subchondral bone in the central weight-bearing ROI on these knee 3D FISP images were quantitatively evaluated for apparent bone volume fraction, trabecular number, spacing, and thickness. BMLs were also evaluated in the subchondral bone immediately adjacent to the articular cartilage. BML volume was also evaluated within the same trabecular morphometry ROI and semi-quantitatively classified as none, small, or large. Kruskal-Wallis test was used to determine if mean apparent bone volume fraction, trabecular number, spacing, or thickness differed by BML score.
Compared to knees with ROIs containing no BMLs, knees with small or large BMLs had statistically higher apparent bone volume fraction (P < 0.01), trabecular number (P < 0.01), and thickness (P = 0.02), and lower trabecular spacing (P < 0.01).
Compared to knees with ROIs containing no BMLs, knees with ROIs containing small or large BMLs had higher apparent bone volume fraction, trabecular number and thickness, but lower trabecular spacing. These findings may represent areas of locally increased bone remodeling or compression.
骨髓病变（BML）是骨关节炎患者常见的磁共振（MR）特征，但它们的病理基础仍知之甚少，并且尚未在体内进行评估。我们的目的是使用基于定量 MR 的小梁形态计量学来评估与同一感兴趣区域（ROI）中存在的和大小的 BML 相关的小梁结构。
158 名参与骨关节炎倡议（OAI）的参与者在同一时段内使用冠状 3D 快速稳态进动（FISP）序列进行小梁形态计量学成像，用于 OAI 3T MR 膝关节评估。这些膝关节 3D FISP 图像的中央承重 ROI 中的近内侧胫骨骨软骨下骨进行了小梁体积分数、小梁数量、间距和厚度的定量评估。还在紧邻关节软骨的软骨下骨中评估了 BML。还在同一小梁形态计量学 ROI 内评估了 BML 体积，并对其进行了半定量分类为无、小或大。Kruskal-Wallis 检验用于确定 BML 评分是否会导致平均表观骨体积分数、小梁数量、间距或厚度不同。
与 ROI 中无 BML 的膝关节相比，ROI 中存在小或大 BML 的膝关节的表观骨体积分数（P<0.01）、小梁数量（P<0.01）和厚度（P=0.02）更高，而小梁间距（P<0.01）更低。
与 ROI 中无 BML 的膝关节相比，ROI 中存在小或大 BML 的膝关节的表观骨体积分数、小梁数量和厚度更高，但小梁间距更低。这些发现可能代表局部骨重建或压缩增加的区域。
