Dautry R, Bousson V, Manelfe J, Perozziello A, Boyer P, Loriaut Ph, Koch P, Silvestre A, Schouman-Claeys E, Laredo J D, Dallaudière B
JBR-BTR. 2014 Jan-Feb;97(1):11-6. doi: 10.5334/jbr-btr.364.
To assess the correlation of T2 mapping abnormalities to knee pain location, in young adults with normal standard knee MRI at 3.0 Tesla.
Twenty-three consecutive patients were included prospectively from September 2011 to April 2012. Inclusion criteria were age under 50 years old, knee pain without surgical history, and normal knee MRI at 3.0 Tesla (sagittal T1-weighted images, and sagittal, axial and coronal proton-density-weighted images with saturation of fat signal). Ten asymptomatic volunteers were also included as a control group. Patients and controls had a cartilage T2 mapping MRI sequence in addition to the standard MRI protocol. Two musculoskeletal radiologists, blinded to the patient/control condition and pain location, independently reviewed the T2 mapping images. T2 values below 40 ms were considered normal. They rated the number of hyaline cartilage lesions and their grade according to an ICRS-like score (inspired by the International Cartilage Research Society score) in each anatomical compartment (medial and lateral femoro-tibial and anterior patello-femoral joints). In addition, the T2 value of the largest lesion was measured. Patient's pain location was classified in the following categories: anterior, lateral, medial and global. T2 mapping findings were compared to pain location, and retrospectively to the initial standard sequences. Sensitivity and specificity were calculated for MRI with T2 mapping according to pain location for each reader. Kappa coefficient was calculated for inter-reader agreement. We used variance analysis in a linear regression to compare T2 values and ICRS-like classification in each compartment.
Sensitivity of MRI with T2 mapping, according to the symptomatic compartment, was respectively: 78% and 87% for Reader 1 and Reader 2 and specificity was 70% for both readers. Kappa coefficient for T2 mapping abnormalities location and pain location was good, with a calculated value of 0.64. There was no significant correlation between ICRS-like classification and T2 values of lesions (p = 0.18).
Our results suggest that T2 mapping is an interesting MRI sequence for the exploration of young patients knee pain in case of normal MRI with a standard protocol, with a good correlation between pain location and focal prolongations of the cartilage T2 relaxation time.
评估3.0特斯拉标准膝关节MRI表现正常的年轻成人中，T2 mapping异常与膝关节疼痛部位的相关性。
前瞻性纳入2011年9月至2012年4月连续就诊的23例患者。纳入标准为年龄小于50岁、无手术史的膝关节疼痛且3.0特斯拉膝关节MRI正常（矢状位T1加权像以及脂肪信号饱和的矢状位、轴位和冠状位质子密度加权像）。还纳入10名无症状志愿者作为对照组。患者和对照组除标准MRI检查外均行软骨T2 mapping MRI序列检查。两名肌肉骨骼放射科医生在不知患者/对照情况及疼痛部位的情况下，独立阅片T2 mapping图像。T2值低于40 ms被视为正常。他们根据类似国际软骨研究学会（ICRS）的评分（受国际软骨研究学会评分启发）对每个解剖部位（内侧和外侧股胫关节以及髌股关节前方）的透明软骨损伤数量及其分级进行评分。此外，测量最大损伤的T2值。患者的疼痛部位分为以下几类：前方、外侧、内侧和全身性。将T2 mapping检查结果与疼痛部位进行比较，并回顾性分析初始标准序列。计算每位阅片者根据疼痛部位的T2 mapping MRI的敏感性和特异性。计算阅片者间一致性的kappa系数。我们在线性回归中使用方差分析比较各部位的T2值和类似ICRS的分类。
根据有症状的部位，T2 mapping MRI的敏感性，阅片者1为78%，阅片者2为87%，两位阅片者的特异性均为70%。T2 mapping异常部位与疼痛部位的kappa系数良好，计算值为0.64。类似ICRS的分类与损伤的T2值之间无显著相关性（p = 0.18）。
我们的结果表明，对于标准MRI正常的年轻患者膝关节疼痛，T2 mapping是一种有趣的MRI序列，疼痛部位与软骨T2弛豫时间的局灶性延长之间具有良好的相关性。
