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评估髋臼发育不良成人软骨退变的放射状分布和使用径向 dGEMRIC 进行对比前测量的必要性。

Evaluation of radial distribution of cartilage degeneration and necessity of pre-contrast measurements using radial dGEMRIC in adults with acetabular dysplasia.

机构信息

Department of Radiology, 4th Medical College of Peking University (Beijing Jishuitan Hospital), 31 Xinjiekou East Street, Beijing, 100035, China.

出版信息

BMC Musculoskelet Disord. 2012 Oct 30;13:212. doi: 10.1186/1471-2474-13-212.

Abstract

BACKGROUND

The purpose of the present study was to investigate the radial distribution patterns of cartilage degeneration in dysplastic hips at different stages of secondary osteoarthritis (OA) by using radial delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), and to assess whether pre-contrast measurements are necessary.

METHODS

Thirty-five hips in 21 subjects (mean age ± SD, 27.6 ± 10.8 years) with acetabular dysplasia (lateral CE angle < 25°) were studied. Severity of OA was assessed on radiographs using Tönnis grading. Pre- (T1pre) and post-contrast T1 (T1Gd) values were measured at 7 sub-regions on radial reformatted slices acquired from a 3-dimensional (3D) T1 mapping sequence using a 1.5 T MR scanner. Values of radial T1pre, T1Gd and ΔR1 (1/T1Gd - 1/T1pre) of subgroups with different severity of OA were compared to those of the subgroup without OA using nonparametric tests, and bivariate linear Pearson correlations between radial T1Gd and ΔR1 were analyzed for each subgroup.

RESULTS

Compared to the subgroup without OA, the subgroup with mild OA was observed with a significant decrease in T1Gd in the anterosuperior to superior sub-regions (mean, 476 ~ 507 ms, p = 0.026 ~ 0.042) and a significant increase in ΔR1 in the anterosuperior to superoposterior and posterior sub-regions (mean, 0.93 ~ 1.37 s-1, p = 0.012 ~ 0.042). The subgroup with moderate to severe OA was observed with a significant overall decrease in T1Gd (mean, 404 ~ 452 ms, p = 0.001 ~ 0.020) and an increase in ΔR1 (mean, 1.17 ~1.69 s-1, p = 0.001 ~ 0.020). High correlations were observed between radial T1Gd and ΔR1 for all subgroups (r = -0.869 ~ -0.944, p < 0.001).

CONCLUSIONS

Radial dGEMRIC without pre-contrast measurements is useful for evaluating different patterns of cartilage degeneration in the entire hip joint of patients with hip dysplasia, particularly for those in early stages of secondary OA.

摘要

背景

本研究旨在通过使用径向延迟钆增强磁共振成像软骨(dGEMRIC)研究不同阶段继发骨关节炎(OA)的发育性髋关节畸形患者软骨退变的放射状分布模式,并评估是否需要预对比测量。

方法

研究了 21 名受试者(平均年龄 ± 标准差,27.6 ± 10.8 岁)的 35 髋髋臼发育不良(外侧 CE 角 < 25°)。使用 Tönnis 分级在 X 线片上评估 OA 的严重程度。使用 1.5 T MR 扫描仪在三维(3D)T1 映射序列的径向重建切片上测量 7 个亚区的预对比(T1pre)和对比后 T1(T1Gd)值。使用非参数检验比较不同 OA 严重程度亚组的径向 T1pre、T1Gd 和 ΔR1(1/T1Gd-1/T1pre)值与无 OA 亚组的相应值,并对每个亚组进行径向 T1Gd 和 ΔR1 之间的双变量线性 Pearson 相关性分析。

结果

与无 OA 亚组相比,轻度 OA 亚组在前上至上部亚区的 T1Gd 显著降低(平均值,476507 ms,p=0.0260.042),在前上至后上和后亚区的 ΔR1 显著增加(平均值,0.931.37 s-1,p=0.0120.042)。中重度 OA 亚组观察到 T1Gd 整体显著降低(平均值,404452 ms,p=0.0010.020)和 ΔR1 增加(平均值,1.171.69 s-1,p=0.0010.020)。所有亚组的径向 T1Gd 和 ΔR1 之间均观察到高度相关性(r=-0.869~-0.944,p<0.001)。

结论

无预对比测量的径向 dGEMRIC 可用于评估髋关节发育不良患者整个髋关节不同模式的软骨退变,特别是在继发 OA 的早期阶段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78d9/3517476/3a77e1f64a0d/1471-2474-13-212-1.jpg

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