Park Do Young, Jin Long Hao, Min Byoung-Hyun, Kwack Kyu-Sung, An Young-Sil, Kim Young Jick
Department of Anatomy, Ajou University School of Medicine, Suwon, Korea.
Department of Orthopedic Surgery, Yanbian University Medical School, Yanbian, China.
Int J Rheum Dis. 2017 Oct;20(10):1393-1402. doi: 10.1111/1756-185X.12909. Epub 2016 Jul 25.
The aim of this study was to analyze subchondral bone scan uptake in osteoarthritic knees with reference to subchondral bone microstructure and articular cartilage histology.
This cross-sectional, laboratory study evaluated 123 human distal femoral condyle specimens of 67 patients after joint replacement surgery. All patients were preoperatively examined with bone scan of the knee joint. Specimens were evaluated for cartilage histology and micro-computed tomography analysis of subchondral bone. Data between bone scan, histology and micro-computed tomography were statistically analyzed using either coefficient of correlation, Student's t-test or one-way analysis of variance with Tukey post hoc test.
Bone scan grading and histological articular cartilage degeneration scores showed significant correlation (r = 0.812, P < 0.001). Both bone scan positive and histologically confirmed osteoarthritis samples showed increase in subchondral trabecular bone volume and thickness, reflected in micro-computed tomography. Overall, positive predictive value (%) of bone scan for osteoarthritic cartilage lesions was 91.9%, and the sensitivity and specificity were 88.3% and 60%, respectively. Histology showed that bone scan has both a high positive predictive and a low negative predictive value for detection of osteoarthritic cartilage lesions.
Bone scan uptake correlated with articular cartilage degeneration in osteoarthritic knees. Bone scan may be a useful diagnostic tool that reflects pathologic changes of cartilage in osteoarthritis.
本研究旨在参照软骨下骨微结构和关节软骨组织学，分析骨关节炎膝关节的软骨下骨扫描摄取情况。
这项横断面实验室研究评估了67例患者关节置换术后的123个人类股骨远端髁标本。所有患者术前均接受膝关节骨扫描检查。对标本进行软骨组织学评估和软骨下骨的微计算机断层扫描分析。使用相关系数、学生t检验或采用Tukey事后检验的单向方差分析对骨扫描、组织学和微计算机断层扫描之间的数据进行统计学分析。
骨扫描分级与组织学关节软骨退变评分显示出显著相关性（r = 0.812，P < 0.001）。骨扫描阳性和组织学确诊为骨关节炎的样本在微计算机断层扫描中均显示软骨下小梁骨体积和厚度增加。总体而言，骨扫描对骨关节炎软骨损伤的阳性预测值（%）为91.9%，敏感性和特异性分别为88.3%和60%。组织学显示，骨扫描对骨关节炎软骨损伤的检测具有较高的阳性预测值和较低的阴性预测值。
骨扫描摄取与骨关节炎膝关节的关节软骨退变相关。骨扫描可能是一种反映骨关节炎软骨病理变化的有用诊断工具。
