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磁共振研究髋关节骨关节炎中股骨近端 3D 形态学形状的纵向变化及其与软骨健康的关系。

MR study of longitudinal variations in proximal femur 3D morphological shape and associations with cartilage health in hip osteoarthritis.

机构信息

Department of Radiology and Biomedical Imaging, University of California-San Francisco, 1700 Fourth Street, Suite 203, QB3 Building, San Francisco 94107, California.

Department of Physical Therapy and Rehabilitation Science, University of California-San Francisco, San Francisco, California.

出版信息

J Orthop Res. 2019 Jan;37(1):161-170. doi: 10.1002/jor.24147. Epub 2018 Oct 16.

Abstract

The goal of this study was to use quantitative MRI analysis to longitudinally observe the relationship between 3D proximal femur shape and hip joint degenerative changes. Forty-six subjects underwent unilateral hip MR imaging at three time points (baseline, 18 and 36 months). 3D shape analysis, hip cartilage T /T relaxation time quantification, and SHOMRI MRI grading were performed at each time point. Subjects were grouped based on KL, SHOMRI, and HOOS pain scores. Associations between these score groupings, time, and longitudinal variation in shape, were analyzed using a generalized estimating equation. One-way ANCOVA was conducted to evaluate change in shape as a predictor of the worsening of degenerative changes at 36 months. Our results demonstrated that subjects displayed an increase in the volume of the femoral head and neck (Mode 3) over time. This shape mode was significantly more prevalent in patients that reported pain. Longitudinal changes in this shape mode also served as borderline predictors of elevated T values (p = 0.055) and of cartilage lesions (p = 0.068). Subjects showed a change in the Femoral Neck Anteversion angle (FNA) over time (Mode 6). This shape mode showed a significant interaction with the presence of cartilage lesions. The results of this study suggest that specific variations in bone shape quantified through 3D-MRI based Statistical Shape modeling show an observable relationship with hip joint compositional and morphological changes. The shapes observed lead to early degenerative changes, which may lead into OA, thus confirming the important role of bone shape changes in the pathogenesis of OA. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

摘要

本研究的目的是使用定量 MRI 分析,从纵向角度观察 3D 股骨近端形态与髋关节退行性改变之间的关系。46 名受试者在三个时间点(基线、18 个月和 36 个月)进行单侧髋关节 MRI 检查。在每个时间点进行 3D 形态分析、髋关节软骨 T/T 弛豫时间定量分析和 SHOMRI MRI 分级。根据 KL、SHOMRI 和 HOOS 疼痛评分将受试者分为不同的组。使用广义估计方程分析这些评分分组、时间和形态的纵向变化之间的关系。单向方差分析用于评估形态变化作为 36 个月时退行性变化恶化的预测因子。我们的结果表明,受试者的股骨头和颈部体积随时间增加(模式 3)。这种形态模式在报告疼痛的患者中更为常见。这种形态模式的纵向变化也作为 T 值升高(p=0.055)和软骨病变(p=0.068)的边界预测因子。受试者的股骨颈前倾角(FNA)随时间变化(模式 6)。这种形态模式与软骨病变的存在存在显著的交互作用。本研究结果表明,通过基于 3D-MRI 的统计形状建模量化的特定骨形状变化与髋关节成分和形态变化之间存在可观察到的关系。观察到的形状导致早期退行性变化,这可能导致 OA,从而证实了骨形状变化在 OA 发病机制中的重要作用。©2018 矫形研究学会。由 Wiley Periodicals, Inc. 出版。J Orthop Res.

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