Chang Eric Y, Pallante-Kichura Andrea L, Bae Won C, Du Jiang, Statum Sheronda, Wolfson Tanya, Gamst Anthony C, Cory Esther, Amiel David, Bugbee William D, Sah Robert L, Chung Christine B
Department of Radiology, VA San Diego Healthcare System ; Department of Radiology, University of California, San Diego Medical Center.
Department of Bioengineering, University of California, San Diego.
Cartilage. 2014 Jan 1;5(1):16-27. doi: 10.1177/1947603513514436.
To describe and apply a semi-quantitative MRI scoring system for multi-feature analysis of cartilage defect repair in the knee by osteochondral allografts, and to correlate this scoring system with histopathologic, micro-computed tomography (μCT), and biomechanical reference standards using a goat repair model.
Fourteen adult goats had two osteochondral allografts implanted into each knee: one in the medial femoral condyle (MFC) and one in the lateral trochlea (LT). At 12 months, goats were euthanized and MRI was performed. Two blinded radiologists independently rated nine primary features for each graft, including cartilage signal, fill, edge integration, surface congruity, calcified cartilage integrity, subchondral bone plate congruity, subchondral bone marrow signal, osseous integration, and presence of cystic changes. Four ancillary features of the joint were also evaluated, including opposing cartilage, meniscal tears, synovitis, and fat-pad scarring. Comparison was made with histological and μCT reference standards as well as biomechanical measures. Interobserver agreement and agreement with reference standards was assessed. Cohen's kappa, Spearman's correlation, and Kruskal-Wallis tests were used as appropriate.
There was substantial agreement (κ>0.6, p<0.001) for each MRI feature and with comparison against reference standards, except for cartilage edge integration (κ=0.6). There was a strong positive correlation between MRI and reference standard scores (ρ=0.86, p<0.01). OCAMRISS was sensitive to differences in outcomes between the types of allografts.
We have described a comprehensive MRI scoring system for osteochondral allografts and have validated this scoring system with histopathologic and μCT reference standards as well as biomechanical indentation testing.
描述并应用一种半定量MRI评分系统，用于对膝关节同种异体骨软骨移植软骨缺损修复进行多特征分析，并使用山羊修复模型将该评分系统与组织病理学、微计算机断层扫描（μCT）和生物力学参考标准进行关联。
14只成年山羊，每只膝关节植入两个同种异体骨软骨移植物：一个植入股骨内侧髁（MFC），一个植入滑车外侧（LT）。12个月时，对山羊实施安乐死并进行MRI检查。两名盲法放射科医生分别对每个移植物的九个主要特征进行评分，包括软骨信号、填充情况、边缘整合度、表面一致性、钙化软骨完整性、软骨下骨板一致性、软骨下骨髓信号、骨整合情况以及囊性变的存在。还评估了关节的四个辅助特征，包括相对的软骨、半月板撕裂、滑膜炎和脂肪垫瘢痕形成。与组织学和μCT参考标准以及生物力学测量结果进行比较。评估观察者间的一致性以及与参考标准的一致性。酌情使用科恩kappa系数、斯皮尔曼相关性分析和克鲁斯卡尔 - 沃利斯检验。
除软骨边缘整合度（κ = 0.6）外，每个MRI特征以及与参考标准比较时均存在高度一致性（κ>0.6，p<0.001）。MRI与参考标准评分之间存在强正相关（ρ = 0.86，p<0.01）。OCAMRISS对不同类型同种异体移植物之间的结果差异敏感。
我们描述了一种用于同种异体骨软骨移植的综合MRI评分系统，并用组织病理学、μCT参考标准以及生物力学压痕测试对该评分系统进行了验证。
