髌下脂肪垫高信号改变与磁共振成像评估膝关节骨关节炎进展的相关性。

Association Between Quantitatively Measured Infrapatellar Fat Pad High Signal-Intensity Alteration and Magnetic Resonance Imaging-Assessed Progression of Knee Osteoarthritis.

机构信息

University of Tasmania, Hobart, Tasmania, Australia, and Zhujiang Hospital, Southern Medical University, Guangzhou, China.

University of Tasmania, Hobart, Tasmania, Australia.

出版信息

Arthritis Care Res (Hoboken). 2019 May;71(5):638-646. doi: 10.1002/acr.23713.

DOI:10.1002/acr.23713

PMID:30044537

Abstract

OBJECTIVE

To describe the cross-sectional and longitudinal associations between quantitative measures of infrapatellar fat pad (IPFP) signal-intensity alteration and knee structural abnormalities in patients with symptomatic knee osteoarthritis (OA).

METHODS

A total of 261 patients (mean ± SD age 63.0 ± 7.2 years) with symptomatic knee OA were selected from a randomized controlled trial with a follow-up of 2 years. IPFP signal-intensity alterations at baseline were quantitatively measured on T2-weighted fat-saturated magnetic resonance imaging using MATLAB. These quantitative measures included the SD of whole IPFP signal intensity measurement, the upper quartile value of high signal intensity (UQ ), the ratio of volume of high signal-intensity alteration to volume of whole IPFP (percentage ), and the clustering effect of high signal intensity (clustering-factor ). Cartilage volume and defects and bone marrow lesions (BMLs) were assessed using validated measures.

RESULTS

Higher baseline SD of the IPFP, UQ , and clustering-factor were associated with greater loss of tibial cartilage volume and larger increases in tibiofemoral cartilage defects over 2 years. Patients with high and medium tertiles of clustering-factor had greater loss of cartilage volume per annum compared with those with a low tertile (for high 4.9%, for medium 4.6%, and for low 3.3% annually). Baseline percentage and clustering-factor were positively and significantly associated with increases in tibiofemoral BMLs over 2 years. Cross-sectional associations between IPFP measures and knee structures were similar but more consistent.

CONCLUSION

Quantitative measures of increased signal intensity in the IPFP were associated with knee structural abnormalities in the tibiofemoral compartment, suggesting that these measurements could be used as an additional entry criterion to enrich studies for faster progressors of knee OA.

摘要

目的

描述髌下脂肪垫（IPFP）信号强度改变的定量测量值与有症状膝关节骨关节炎（OA）患者膝关节结构异常的横断面和纵向关联。

方法

从一项为期 2 年的随机对照试验中选择了 261 名有症状膝关节 OA 患者（平均年龄±标准差 63.0±7.2 岁）。使用 MATLAB 在 T2 加权脂肪饱和磁共振成像上对髌下脂肪垫信号强度改变进行定量测量。这些定量测量包括整个髌下脂肪垫信号强度测量的标准差（SD）、高信号强度的上四分位数（UQ）、高信号强度改变体积与整个髌下脂肪垫体积的比值（百分比）和高信号强度的聚类效应（聚类因子）。使用验证后的指标评估软骨体积和缺损以及骨髓病变（BML）。

结果

较高的基线 IPFP SD、UQ 和聚类因子与 2 年内胫骨软骨体积的更大损失和髌股软骨缺损的更大增加有关。聚类因子高和中 tertiles 的患者每年的软骨体积损失比低 tertiles 的患者更大（高 tertiles 每年 4.9%，中 tertiles 每年 4.6%，低 tertiles 每年 3.3%）。基线百分比和聚类因子与髌股 BML 增加呈正相关且具有统计学意义，超过 2 年。IPFP 测量值与膝关节结构之间的横断面关联相似，但更一致。