Heilmeier Ursula, Wamba John Mbapte, Joseph Gabby B, Darakananda Karin, Callan Jennifer, Neumann Jan, Link Thomas M
Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Lobby 6, Suite, San Francisco, CA, 350, USA.
Skeletal Radiol. 2019 Jan;48(1):89-101. doi: 10.1007/s00256-018-2995-4. Epub 2018 Jun 30.
To evaluate if baseline pathological knee conditions as assessed via single features of the MR-based Whole-Organ Magnetic Resonance Imaging Scoring (WORMS), standard T2, and T2 gray-level co-occurrence matrix (GLCM) texture parameters of knee cartilage can serve as potential long-term radiological predictors of incident total knee arthroplasty (TKA) 4-7 years later.
Baseline 3-T knee MRIs of 309 subjects from the Osteoarthritis Initiative (n = 81 TKA cases, with right-knee TKA 4-7 years after enrolment, and n = 228 TKA-free matched controls) were evaluated for the presence and severity of pathological knee conditions via modified WORMS. Knee cartilage was segmented and standard T2 cartilage and T2 GLCM texture measures (contrast, variance) were computed. Statistical analysis employed conditional logistic regression.
We found that a one-point increase on the joint effusion scale, the bone marrow edema scale or on the cartilage lesion scale at baseline predicted incident TKA (ORs: 2.45, 1.65, and 1.37 respectively (p ≤ 0.003)). For T2 cartilage measurements, we observed that in the lateral femur, a 1-SD increase in T2 relaxation time yielded a 28% increase in the odds of TKA (1.28 [1.09-1.643], p = 0.046). When looking at cartilage texture, we similarly noted that a 1-SD increase in the cartilage texture parameter "contrast" was associated with a 33-40% increased risk of incident TKA in the lateral femur and tibia (0.003 ≤ p ≤ 0.021), as was a 1-SD increase in the texture parameter "variance" in the lateral femur (p = 0.002).
Radiological evaluation of standard knee MR images via single WORMS features and T2 standard and texture analysis at baseline can help predict the patient's individual risk for an incident TKA 4-7 years later.
评估基于磁共振成像的全器官磁共振成像评分（WORMS）的单一特征、标准T2以及膝关节软骨的T2灰度共生矩阵（GLCM）纹理参数所评估的基线病理性膝关节状况，是否可作为4至7年后全膝关节置换术（TKA）发生率的潜在长期影像学预测指标。
对来自骨关节炎倡议组织的309名受试者的基线3-T膝关节磁共振成像（81例TKA病例，入组后4至7年进行右膝TKA；228例无TKA的匹配对照），通过改良的WORMS评估病理性膝关节状况的存在及严重程度。对膝关节软骨进行分割，并计算标准T2软骨和T2 GLCM纹理测量值（对比度、方差）。统计分析采用条件逻辑回归。
我们发现，基线时关节积液量表、骨髓水肿量表或软骨损伤量表上增加1分可预测TKA的发生（比值比分别为：2.45、1.65和1.37（p≤0.003））。对于T2软骨测量，我们观察到，在股骨外侧，T2弛豫时间增加1个标准差，TKA发生几率增加28%（1.28[1.09 - 1.643]，p = 0.046）。在观察软骨纹理时，我们同样注意到，软骨纹理参数“对比度”增加1个标准差，与股骨外侧和胫骨TKA发生风险增加33%至40%相关（0.003≤p≤0.021），股骨外侧纹理参数“方差”增加1个标准差也与之相关（p = 0.002）。
通过基线时WORMS单一特征以及T2标准和纹理分析对标准膝关节磁共振图像进行影像学评估，有助于预测患者4至7年后发生TKA的个体风险。
