Department of Radiology, University of Alberta Hospital & Stollery Children's Hospital, 2J2.00 WC Mackenzie Health Sciences Centre, University of Alberta, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada.
Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
Skeletal Radiol. 2021 Apr;50(4):781-787. doi: 10.1007/s00256-020-03630-6. Epub 2020 Sep 30.
Accurate joint fluid quantification on MRI cannot simply rely on measuring the maximum fluid depth or using an ellipsoid approximation as this does not fully characterize the complex shape of a fluid-filled joint. As per the Outcome Measurement in Rheumatology (OMERACT) filter, we sought to evaluate the feasibility, reliability, and validity of a semi-automated supervised technique to quantify hip effusion volume.
Ninety-three hip osteoarthritis patients were imaged with coronal short TI inversion recovery (STIR) and sagittal intermediate weighted fat-suppressed (IWFS) sequences at two time points (Fig. 1). Volumetric quantitative measurement (VQM) of joint fluid and measurement of the largest femoral neck fluid thickness (FTM) was performed using the custom MATLAB software. Self-reported Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and clinical measures of pain, stiffness, and function were recorded.
Inter-observer reliability was significantly higher for VQM than FTM (ICC = 0.96 vs. 0.85, p < 0.05). VQM and FTM correlated moderately (r = 0.76, p < 0.0001). There was significantly more articular fluid in symptomatic than asymptomatic hips at baseline (mean = 9.8 vs. 5.9 mL). Volumetric quantitative measurement generally displayed more frequent and stronger correlations to clinical parameters than FTM. Volumetric quantitative measurement required 3.9 min/hip vs. < 1 min/hip for femoral neck fluid thickness.
Volumetric quantitative measurement of joint effusion can serve as an MRI gold-standard, could apply to other joints and collections, and is highly suited to future automation.
MRI 上关节液的准确定量不能仅仅依靠测量最大液深或使用椭圆体近似值，因为这不能完全描述充满液体的关节的复杂形状。根据关节磁共振成像（OMERACT）滤过器标准，我们旨在评估一种半自动监督技术定量髋关节积液量的可行性、可靠性和有效性。
93 例髋骨关节炎患者在两个时间点进行冠状短 TI 反转恢复（STIR）和矢状中间加权脂肪抑制（IWFS）序列成像（图 1）。使用定制的 MATLAB 软件对关节液进行容积定量测量（VQM）和测量最大股骨颈液厚（FTM）。记录患者的自我报告的西部安大略省和麦克马斯特大学骨关节炎指数（WOMAC）和疼痛、僵硬和功能的临床测量结果。
VQM 的观察者间可靠性明显高于 FTM（ICC = 0.96 对 0.85，p < 0.05）。VQM 和 FTM 中度相关（r = 0.76，p < 0.0001）。在基线时，有症状的髋关节中的关节液明显多于无症状髋关节（平均值= 9.8 对 5.9 mL）。与 FTM 相比，容积定量测量通常与临床参数具有更频繁和更强的相关性。VQM 测量需要 3.9 分钟/髋关节，而测量股骨颈液厚则需要< 1 分钟/髋关节。
关节积液的容积定量测量可作为 MRI 的金标准，可应用于其他关节和积液，并且非常适合未来的自动化。
