定量 3D 超短回波时间磁化传递成像用于体内膝关节软骨退变的评估。
Quantitative 3D Ultrashort Echo Time Magnetization Transfer Imaging for Evaluation of Knee Cartilage Degeneration In Vivo.
机构信息
Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Radiology, University of California San Diego, La Jolla, California, USA.
出版信息
J Magn Reson Imaging. 2021 Oct;54(4):1294-1302. doi: 10.1002/jmri.27659. Epub 2021 Apr 24.
BACKGROUND
Recent studies suggest that macromolecular fraction (MMF) derived from three-dimensional ultrashort echo time magnetization transfer (UTE-MT) imaging is insensitive to the magic angle effect. However, its clinical use in osteoarthritis (OA) remains to be investigated.
PURPOSE
To investigate the feasibility of 3D UTE-MT-derived MMF in differentiating normal from degenerated cartilage.
STUDY TYPE
Prospective.
SUBJECTS
Sixty-two participants (54.8 ± 16.7 years, 30 females) with and without OA, plus two healthy volunteers (mean age 35.0 years) for reproducibility test.
FIELD STRENGTH/SEQUENCE: 3 T/UTE-MT sequence.
ASSESSMENT
A 3D UTE-MT sequence was employed to calculate MMF based on a two-pool model. Kellgren-Lawrence (KL) grade and Whole-Organ Magnetic Resonance Imaging Score (WORMS) were evaluated by three experienced musculoskeletal radiologists. KL grade was condensed into three groups: KL0, KL1-2, and KL3-4. WORMS was regrouped based on extent of lesion (extent group) and depth of lesion (depth group), respectively. The performance of MMF at evaluating the degeneration of cartilage was assessed via Spearman's correlation coefficient and the area under the curve (AUC) calculated according to the receiver-operating characteristic curve.
STATISTICAL TESTS
After normality check, one-way analysis of variance was used to evaluate the performance. Tukey-Kramer test was performed for post hoc testing.
RESULTS
MMF showed significant negative correlations with KL grade (r = -0.53, P < 0.05) and WORMS (r = -0.49, P < 0.05). Significantly lower MMFs were found in subjects with greater KL grade (11.8 ± 0.8% for KL0; 10.9 ± 0.9% for KL1-2; 10.6 ± 1.1% for KL3-4; P < 0.05) and in cartilage with greater extent (12.1 ± 1.6% for normal cartilage; 10.9 ± 1.6% for regional lesions; 9.6 ± 1.7% for diffuse lesions; P < 0.05) and depth (12.1 ± 1.6% for normal cartilage; 10.6 ± 1.6% for partial-thickness lesions; 8.8 ± 1.7% for full-thickness lesions; P < 0.05) of lesions. AUC values of MMF for doubtful-minimal OA (KL1-2) and mild cartilage degradation (WORMS1-2) were 0.8 and 0.7, respectively.
DATA CONCLUSION
This study highlights the clinical potential of MMF in the detection of early OA.
LEVEL OF EVIDENCE
2 TECHNICAL EFFICACY STAGE: 2.
背景
最近的研究表明，三维超短回波时间磁化传递（UTE-MT）成像的大分子分数（MMF）对魔角效应不敏感。然而，其在骨关节炎（OA）中的临床应用仍有待研究。
目的
探讨 3D UTE-MT 衍生 MMF 区分正常和退变软骨的可行性。
研究类型
前瞻性。
受试者
62 名参与者（54.8±16.7 岁，30 名女性）和无 OA 的参与者，加上两名健康志愿者（平均年龄 35.0 岁）用于重复性测试。
磁场强度/序列：3T/UTE-MT 序列。
评估
采用 3D UTE-MT 序列基于双池模型计算 MMF。三位有经验的肌肉骨骼放射科医生评估 Kellgren-Lawrence（KL）分级和全器官磁共振成像评分（WORMS）。KL 分级分为三组：KL0、KL1-2 和 KL3-4。WORMS 根据病变范围（范围组）和病变深度（深度组）进行重新分组。通过 Spearman 相关系数评估 MMF 在评估软骨退变中的性能，并根据受试者工作特征曲线计算曲线下面积（AUC）。
统计检验
在正态性检验后，采用单因素方差分析评估性能。采用 Tukey-Kramer 检验进行事后检验。
结果
MMF 与 KL 分级（r=-0.53，P<0.05）和 WORMS（r=-0.49，P<0.05）呈显著负相关。KL 分级较高的患者（KL0 为 11.8±0.8%；KL1-2 为 10.9±0.9%；KL3-4 为 10.6±1.1%；P<0.05）和病变范围较大的患者（正常软骨为 12.1±1.6%；区域性病变为 10.9±1.6%；弥漫性病变为 9.6±1.7%；P<0.05）和病变深度较大的患者（正常软骨为 12.1±1.6%；部分厚度病变为 10.6±1.6%；全层病变为 8.8±1.7%；P<0.05）的 MMF 值显著降低。MMF 对可疑最小 OA（KL1-2）和轻度软骨退变（WORMS1-2）的 AUC 值分别为 0.8 和 0.7。
数据结论
本研究强调了 MMF 在早期 OA 检测中的临床潜力。
证据水平
2 技术功效阶段：2。
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