Calixto Nathaniel E, Kumar Deepak, Subburaj Karupppasamy, Singh Justin, Schooler Joseph, Nardo Lorenzo, Li Xiaojuan, Souza Richard B, Link Thomas M, Majumdar Sharmila
Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California.
Division of Physical Therapy, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina.
J Orthop Res. 2016 Feb;34(2):249-61. doi: 10.1002/jor.23004. Epub 2015 Aug 12.
This study assessed the effects of static loading on MRI relaxation times of menisci in individuals with and without radiographic knee OA. High-resolution fast spin-echo (FSE) and T(1ρ)/T(2) relaxation time MR sequences were obtained with and without loading at 50% body weight in 124 subjects. T(1ρ)/T(2) relaxation times were calculated in menisci, and meniscus lesions were assessed through clinical grading. Student's t-test compared OA and control unloaded relaxation times as well as within-group changes with loading, Generalized Linear Models evaluated zonal variation, and ANCOVA compared loading response between groups. Unloaded T(1ρ) and T(2) in the middle and inner zones of the lateral anterior horn and outer zone of the medial posterior horn were significantly higher in OA and suggest that meniscal OA change occurs unevenly. Zonal T(1ρ) and T(2) showed differing patterns between anterior and posterior horns, suggesting differences in macromolecular organization. Significant increases with loading were seen largely in the T(2) of controls and less frequently in subjects with OA. In the medial posterior horn, T(1ρ) and T(2) decreased with loading in OA but changed negligibly in controls; these significantly different loading responses between groups may indicate load transmission failure in OA menisci.
本研究评估了静态负荷对有和没有膝关节放射学骨关节炎(OA)的个体半月板MRI弛豫时间的影响。在124名受试者中,分别在50%体重负荷和无负荷状态下,采用高分辨率快速自旋回波(FSE)以及T(1ρ)/T(2)弛豫时间磁共振序列进行检查。计算半月板的T(1ρ)/T(2)弛豫时间,并通过临床分级评估半月板损伤情况。采用学生t检验比较OA组和对照组无负荷时的弛豫时间以及负荷状态下组内的变化,使用广义线性模型评估区域差异,采用协方差分析比较组间的负荷反应。外侧前角中部和内侧、内侧后角外侧区域无负荷时的T(1ρ)和T(2)在OA组显著更高,提示半月板OA改变不均匀发生。前后角的区域T(1ρ)和T(2)呈现不同模式,提示大分子组织存在差异。负荷状态下,对照组的T(2)大多显著增加,而OA患者中较少见。在内侧后角,OA组的T(1ρ)和T(2)随负荷增加而降低,而对照组变化可忽略不计;组间这些显著不同的负荷反应可能表明OA半月板存在负荷传递失败。