3T MRI 下生化软骨成像技术的比较。

Comparison of biochemical cartilage imaging techniques at 3 T MRI.

机构信息

Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.

Department of Orthopedics and Trauma Surgery, University Hospital Heidelberg, Germany.

出版信息

Osteoarthritis Cartilage. 2014 Oct;22(10):1732-42. doi: 10.1016/j.joca.2014.04.020.

DOI:10.1016/j.joca.2014.04.020

PMID:25278082

Abstract

OBJECTIVE

To prospectively compare chemical-exchange saturation-transfer (CEST) with delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) and T2 mapping to assess the biochemical cartilage properties of the knee.

METHOD

Sixty-nine subjects were prospectively included (median age, 42 years; male/female = 32/37) in three cohorts: 10 healthy volunteers, 40 patients with clinically suspected cartilage lesions, and 19 patients about 1 year after microfracture therapy. T2 mapping, dGEMRIC, and CEST were performed at a 3 T MRI unit using a 15-channel knee coil. Parameter maps were evaluated using region-of-interest analysis of healthy cartilage, areas of chondromalacia and repair tissue. Differentiation of damaged from healthy cartilage was assessed using receiver-operating characteristic (ROC) analysis.

RESULTS

Chondromalacia grade 2-3 had significantly higher CEST values (P = 0.001), lower dGEMRIC (T1-) values (P < 0.001) and higher T2 values (P < 0.001) when compared to the normal appearing cartilage. dGEMRIC and T2 mapping correlated moderately negative (Spearman coefficient r = -0.56, P = 0.0018) and T2 mapping and CEST moderately positive (r = 0.5, P = 0.007), while dGEMRIC and CEST did not significantly correlate (r = -0.311, P = 0.07). The repair tissue revealed lower dGEMRIC values (P < 0.001) and higher CEST values (P < 0.001) with a significant negative correlation (r = -0.589, P = 0.01), whereas T2 values were not different (P = 0.54). In healthy volunteers' cartilage, CEST and dGEMRIC showed moderate positive correlation (r = 0.56), however not reaching significance (P = 0.09). ROC-analysis demonstrated non-significant differences of T2 mapping vs CEST (P = 0.14), CEST vs dGEMRIC (P = 0.89), and T2 mapping vs dGEMRIC (P = 0.12).

CONCLUSION

CEST is able to detect normal and damaged cartilage and is non-inferior in distinguishing both when compared to dGEMRIC and T2 mapping.

摘要

目的

前瞻性比较化学交换饱和转移（CEST）与延迟钆增强 MRI 软骨成像（dGEMRIC）和 T2 映射，以评估膝关节的生化软骨特性。

方法

将 69 例受试者前瞻性纳入三个队列：10 例健康志愿者、40 例临床疑似软骨病变患者和 19 例微骨折治疗后约 1 年的患者。在 3T MRI 单元上使用 15 通道膝关节线圈进行 T2 映射、dGEMRIC 和 CEST。使用感兴趣区分析健康软骨、软骨软化区和修复组织，评估参数图。使用受试者工作特征（ROC）分析评估区分受损与健康软骨的能力。

结果

与正常外观软骨相比，软骨软化 2-3 级的 CEST 值明显升高（P = 0.001），dGEMRIC（T1-）值明显降低（P < 0.001），T2 值明显升高（P < 0.001）。dGEMRIC 和 T2 映射呈中度负相关（Spearman 系数 r = -0.56，P = 0.0018），T2 映射和 CEST 呈中度正相关（r = 0.5，P = 0.007），而 dGEMRIC 和 CEST 相关性不显著（r = -0.311，P = 0.07）。修复组织的 dGEMRIC 值较低（P < 0.001），CEST 值较高（P < 0.001），且呈显著负相关（r = -0.589，P = 0.01），而 T2 值无差异（P = 0.54）。在健康志愿者的软骨中，CEST 和 dGEMRIC 呈中度正相关（r = 0.56），但无统计学意义（P = 0.09）。ROC 分析表明 T2 映射与 CEST（P = 0.14）、CEST 与 dGEMRIC（P = 0.89）、T2 映射与 dGEMRIC（P = 0.12）的差异均无统计学意义。