Liebl Hans, Joseph Gabby, Nevitt Michael C, Singh Nathan, Heilmeier Ursula, Subburaj Karupppasamy, Jungmann Pia M, McCulloch Charles E, Lynch John A, Lane Nancy E, Link Thomas M
Institut fuer diagnostische und interventionelle Roentgendiagnostik, Technische Universitaet Muenchen, Munich Germany.
Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.
Ann Rheum Dis. 2015 Jul;74(7):1353-9. doi: 10.1136/annrheumdis-2013-204157. Epub 2014 Mar 10.
To evaluate whether T2 relaxation time measurements obtained at 3 T MRI predict the onset of radiographic knee osteoarthritis (OA).
We performed a nested case-control study of incident radiographic knee OA in the Osteoarthritis Initiative cohort. Cases were 50 knees with baseline Kellgren-Lawrence (KL) grade of 0 that developed KL grade of 2 or more over a 4-year period. Controls were 80 knees with KL grade of 0 after 4 years of follow-up. Baseline T2 relaxation time measurements and laminar analysis of T2 in deep and superficial layers were performed in all knee compartments. The association of T2 values with incident OA was assessed with logistic regression and differences in T2 values by case-control status with linear regression, adjusting for age, sex, body mass index (BMI) and other covariates.
Baseline T2 values in all compartments except the medial tibia were significantly higher in knees that developed OA compared with controls and were particularly elevated in the superficial cartilage layers in all compartments. There was an increased likelihood of incident knee OA associated with higher baseline T2 values, particularly in the patella, adjusted OR per 1 SD increase in T2 (3.37 (95% CI 1.72 to 6.62)), but also in the medial femur (1.90 (1.07 to 3.39)), lateral femur (2.17 (1.11 to 4.25)) and lateral tibia (2.23 (1.16 to 4.31)).
These findings suggest that T2 values assessed when radiographic changes are not yet apparent may be useful in predicting the development of radiological tibiofemoral OA.
评估在3T磁共振成像（MRI）下获得的T2弛豫时间测量值能否预测膝关节影像学骨关节炎（OA）的发病。
我们在骨关节炎倡议队列中对膝关节影像学OA的发病进行了一项巢式病例对照研究。病例为50个膝关节，其基线Kellgren-Lawrence（KL）分级为0，在4年期间发展为KL分级2级或更高。对照为随访4年后KL分级为0的80个膝关节。对所有膝关节腔进行基线T2弛豫时间测量以及深层和浅层T2的分层分析。通过逻辑回归评估T2值与OA发病的关联，并通过线性回归分析病例组与对照组T2值的差异，同时对年龄、性别、体重指数（BMI）和其他协变量进行校正。
与对照组相比，发生OA的膝关节中除内侧胫骨外所有腔室的基线T2值均显著更高，且在所有腔室的浅层软骨层中尤其升高。基线T2值越高，发生膝关节OA的可能性越大，特别是在髌骨，T2每增加1个标准差，校正后的比值比为3.37（95%可信区间1.72至6.62），在内侧股骨（1.90（1.07至3.39））、外侧股骨（2.17（1.11至4.25））和外侧胫骨（2.23（1.16至4.31））中也是如此。
这些发现表明，在影像学改变尚不明显时评估的T2值可能有助于预测胫股关节影像学OA的发展。
