动态对比增强 MRI 测量髌股疼痛患者髌骨关节骨血灌注：一项病例对照研究。
Blood perfusion of patellar bone measured by dynamic contrast-enhanced MRI in patients with patellofemoral pain: A case-control study.
机构信息
Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
出版信息
J Magn Reson Imaging. 2018 Nov;48(5):1344-1350. doi: 10.1002/jmri.26174. Epub 2018 May 7.
BACKGROUND
Altered perfusion might play an important role in the pathophysiology of patellofemoral pain (PFP), a common knee complaint with unclear pathophysiology.
PURPOSE
To investigate differences in dynamic contrast-enhanced (DCE)-MRI perfusion parameters between patients with PFP and healthy control subjects.
POPULATION/SUBJECTS/PHANTOM/SPECIMEN/ANIMAL MODEL: Thirty-five adult patients with PFP and 44 healthy adult control subjects.
FIELD STRENGTH/SEQUENCE: 3T DCE-MRI consisting of a sagittal, anterior-posterior, frequency-encoded, fat-suppressed 3D spoiled gradient-echo sequence with intravenous contrast administration.
ASSESSMENT
Patellar bone volumes of interest (VOIs) were delineated by a blinded observer. Quantitative perfusion parameters (k and k ) were calculated from motion-compensated DCE-MRI data by fitting Tofts' model. Weighted mean and unweighted median values of k and k were computed within the patellar bone VOIs.
STATISTICAL TESTS
Differences in patellar bone perfusion parameters were compared between groups by linear regression analyses, adjusted for confounders.
RESULTS
Mean differences of weighted mean and unweighted median were 0.0039 (95% confidence interval [CI] -0.0013; 0.0091) and 0.0052 (95% CI -0.0078; 0.018) for k , and 0.046 (95% CI -0.021; 0.11) and 0.069 (95% CI -0.017; 0.15) for k , respectively. All perfusion parameters were not significantly different between groups (P-values: 0.32; 0.47 for k , and 0.24; 0.15) for k . However, a significant difference in variance between populations was observed for k (P-value 0.007).
DATA CONCLUSION
Higher patellar bone perfusion parameters were found in patients with PFP when compared to healthy control subjects, but these differences were not statistically significant. This result, and the observed significant difference in k variance, warrant further research.
LEVEL OF EVIDENCE
1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1344-1350.
背景
改变的灌注可能在髌股疼痛（PFP）的病理生理学中发挥重要作用，PFP 是一种常见的膝关节疾病，其病理生理学尚不清楚。
目的
研究髌股疼痛患者与健康对照组之间动态对比增强（DCE）-MRI 灌注参数的差异。
人群/受试者/模型/标本/动物：35 例髌股疼痛患者和 44 例健康成人对照组。
磁场强度/序列：3T DCE-MRI 由矢状、前后、频率编码、脂肪抑制 3D 扰相梯度回波序列组成，静脉内对比剂给药。
评估
由一位盲法观察者对髌骨关节骨感兴趣区（VOI）进行描绘。通过拟合 Tofts 模型，从运动补偿的 DCE-MRI 数据中计算定量灌注参数（k 和 k ）。在髌骨关节骨 VOI 内计算 k 和 k 的加权均值和非加权中位数。
统计学检验
通过线性回归分析，在调整混杂因素后，比较组间髌骨关节骨灌注参数的差异。
结果
k 的加权均值和非加权中位数的平均差异分别为 0.0039（95%置信区间 [CI] -0.0013；0.0091）和 0.0052（95% CI -0.0078；0.018），k 的差异分别为 0.046（95% CI -0.021；0.11）和 0.069（95% CI -0.017；0.15）。两组间所有灌注参数均无统计学差异（P 值：k 为 0.32；0.47，k 为 0.24；0.15）。然而，观察到 k 之间的群体方差存在显著差异（P 值<0.007）。
数据结论
与健康对照组相比，髌股疼痛患者的髌骨关节骨灌注参数较高，但这些差异无统计学意义。这一结果，以及观察到的 k 方差的显著差异，需要进一步研究。
证据水平
1 技术功效：第 3 阶段 J. Magn. Reson. Imaging 2018；47：1344-1350.
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