Roemer Frank W, Guermazi Ali, Collins Jamie E, Losina Elena, Nevitt Michael C, Lynch John A, Katz Jeffrey N, Kwoh C Kent, Kraus Virginia B, Hunter David J
Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building, 3rd floor, 820 Harrison Avenue, Boston, MA, 02118, USA.
Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany.
BMC Musculoskelet Disord. 2016 Nov 10;17(1):466. doi: 10.1186/s12891-016-1310-6.
To describe the scoring methodology and MRI assessments used to evaluate the cross-sectional features observed in cases and controls, to define change over time for different MRI features, and to report the extent of changes over a 24-month period in the Foundation for National Institutes of Health Osteoarthritis Biomarkers Consortium study nested within the larger Osteoarthritis Initiative (OAI) Study.
We conducted a nested case-control study. Cases (n = 406) were knees having both radiographic and pain progression. Controls (n = 194) were knee osteoarthritis subjects who did not meet the case definition. Groups were matched for Kellgren-Lawrence grade and body mass index. MRIs were acquired using 3 T MRI systems and assessed using the semi-quantitative MOAKS system. MRIs were read at baseline and 24 months for cartilage damage, bone marrow lesions (BML), osteophytes, meniscal damage and extrusion, and Hoffa- and effusion-synovitis. We provide the definition and distribution of change in these biomarkers over time.
Seventy-three percent of the cases had subregions with BML worsening (vs. 66 % in controls) (p = 0.102). Little change in osteophytes was seen over 24 months. Twenty-eight percent of cases and 10 % of controls had worsening in meniscal scores in at least one subregion (p < 0.001). Seventy-three percent of cases and 53 % of controls had at least one area with worsening in cartilage surface area (p < 0.001). More cases experienced worsening in Hoffa- and effusion synovitis than controls (17 % vs. 6 % (p < 0.001); 41 % vs. 18 % (p < 0.001), respectively).
A wide range of MRI-detected structural pathologies was present in the FNIH cohort. More severe changes, especially for BMLs, cartilage and meniscal damage, were detected primarily among the case group suggesting that early changes in multiple structural domains are associated with radiographic worsening and symptomatic progression.
描述用于评估病例组和对照组中观察到的横断面特征的评分方法和MRI评估，定义不同MRI特征随时间的变化，并报告在国立卫生研究院骨关节炎生物标志物联盟研究（该研究嵌套于更大规模的骨关节炎倡议（OAI）研究中）中24个月期间的变化程度。
我们进行了一项嵌套病例对照研究。病例组（n = 406）为具有影像学进展和疼痛进展的膝关节。对照组（n = 194）为不符合病例定义的膝骨关节炎受试者。两组在Kellgren-Lawrence分级和体重指数方面进行匹配。使用3T MRI系统采集MRI图像，并使用半定量MOAKS系统进行评估。在基线和24个月时读取MRI图像，以评估软骨损伤、骨髓病变（BML）、骨赘、半月板损伤和挤出，以及Hoffa滑膜炎和积液性滑膜炎。我们提供了这些生物标志物随时间变化的定义和分布情况。
73%的病例存在BML恶化的亚区域（对照组为66%）（p = 0.102）。在24个月期间骨赘变化不大。28%的病例和10%的对照组至少有一个亚区域的半月板评分恶化（p < 0.001）。73%的病例和53%的对照组至少有一个区域的软骨表面积恶化（p < 0.001）。与对照组相比，更多病例的Hoffa滑膜炎和积液性滑膜炎恶化（分别为17%对6%（p < 0.001）；41%对18%（p < 0.001））。
FNIH队列中存在多种MRI检测到的结构病变。更严重的变化，尤其是BML、软骨和半月板损伤，主要在病例组中被检测到，这表明多个结构域的早期变化与影像学恶化和症状进展相关。
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