基于 MRI 的半定量评分系统评估半月板部分切除术与膝关节退行性疾病的关系：来自 Osteoarthritis Initiative 的数据。
Introduction of an MR-based semi-quantitative score for assessing partial meniscectomy and relation to knee joint degenerative disease: data from the Osteoarthritis Initiative.
机构信息
Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94107, USA.
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Eur Radiol. 2019 Jun;29(6):3262-3272. doi: 10.1007/s00330-018-5924-y. Epub 2019 Jan 7.
OBJECTIVES
To develop an MR-based semi-quantitative meniscus scoring technique for postoperative assessment of the degree of meniscal resection, to test its reproducibility, and to study the relationship between the amount of resection and degenerative disease burden.
METHODS
We studied the right knee of 135 participants from the Osteoarthritis Initiative that underwent meniscal surgery an average of 14 years previously. The amount of meniscal resection was assessed on baseline 3.0-T MRIs and calculated as meniscus resection score (MenRS) with a range of 0 to 18. Knee abnormalities at baseline and 48 months were graded using a modified Whole-Organ Magnetic Resonance Imaging Score (WORMS). Subjects were also stratified according to meniscal resection performed after injury versus without preceding injury. Statistical analysis included intra-class correlation coefficient (ICC) to determine reproducibility as well as regression models and partial correlations to correlate MenRS with WORMS outcomes.
RESULTS
ICC values for intra- and inter-observer reproducibility of MenRS were 0.980 and 0.977, respectively. Overall, the amount of meniscal resection showed a significant correlation with baseline WORMS grades: higher MenRS was associated with higher total WORMS grades (p = 0.004) and cartilage (p = 0.004) and ligament (p < 0.001) subscores. However, no significant association between MenRS and change in WORMS grades over 48 months was found. The relationship between MenRS and baseline WORMS grades did not change after adjusting for a reported history of knee injury.
CONCLUSIONS
Postoperative assessment of the knee following partial meniscectomy using the newly developed MenRS showed excellent reproducibility and significant cross-sectional correlation with WORMS gradings.
KEY POINTS
• The newly developed semi-quantitative MR-based meniscal resection score demonstrated excellent reproducibility. • A significant correlation between the amount of meniscal resection measured using the newly developed score and the degree of overall knee joint degenerative disease and cartilage defects was found.
目的
开发一种基于磁共振（MR）的半月板切除术后半定量评分技术，用于评估半月板切除程度，检验其可重复性，并研究切除量与退行性疾病负担之间的关系。
方法
我们研究了平均在 14 年前接受过半月板手术的 Osteoarthritis Initiative 项目的 135 名参与者的右膝。在基线 3.0-T MRI 上评估半月板切除量，并使用范围为 0 至 18 的半月板切除评分（MenRS）进行评估。使用改良的全关节磁共振成像评分（WORMS）对基线和 48 个月时的膝关节异常进行分级。根据损伤后或无先前损伤进行的半月板切除对受试者进行分层。统计分析包括计算组内相关系数（ICC）以确定可重复性，以及回归模型和偏相关来评估 MenRS 与 WORMS 结果的相关性。
结果
MenRS 的观察者内和观察者间的 ICC 值分别为 0.980 和 0.977。总体而言，半月板切除量与基线 WORMS 分级有显著相关性：较高的 MenRS 与较高的总 WORMS 分级（p=0.004）和软骨（p=0.004）和韧带（p<0.001）亚评分相关。然而，在 48 个月时，MenRS 与 WORMS 分级的变化之间没有显著关联。在调整报告的膝关节损伤史后，MenRS 与基线 WORMS 分级之间的关系没有改变。
结论
使用新开发的 MenRS 对部分半月板切除术后的膝关节进行术后评估，显示出良好的可重复性和与 WORMS 分级的显著横断面相关性。
关键点
新开发的基于磁共振的半月板切除半定量评分具有良好的可重复性。
新开发的评分系统测量的半月板切除量与膝关节整体退行性疾病和软骨缺损的程度之间存在显著相关性。
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