Shao Hongda, Yang Jiawei, Ma Yajun, Su Xiaolian, Tang Guangyu, Jiang Junjie, Du Jiang, Liu Jianjun
Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Quant Imaging Med Surg. 2022 Mar;12(3):1738-1749. doi: 10.21037/qims-21-550.
The quantitative MR techniques developed rapidly, vary MR-biomarkers have shown the ability to assess the quality of articular cartilage. This study aimed to investigate the diagnostic efficacy of multi-parametric quantitative ultrashort echo time (UTE)-based MRI for evaluating human cartilage degeneration.
Twenty fresh anterolateral femoral condyle samples were obtained from 20 patients (age, 58.8±6.6 years; 6 females) who underwent total knee arthroplasty due to primary osteoarthritis (OA). The samples were imaged using UTE-based magnetization transfer (UTE-MT), UTE-based adiabatic T1ρ (UTE-AdiabT1ρ), UTE-based T2* (UTE-T2*), and CubeQuant-T2 sequences. Cartilage degeneration was classified based on the OA Research Society International grade and polarized light microscopy (PLM) collagen organization score. Spearman's correlation analysis was used to determine the relationships between quantitative MRI biomarkers [UTE-MT ratio (UTE-MTR), UTE-AdiabT1ρ, UTE-T2*, and CubeQuant-T2], OA Research Society International grade, and PLM collagen organization score. The diagnostic efficacy of each MRI biomarker for the detection of mild cartilage degeneration was assessed using the area under the receiver operating characteristic (ROC) curve (AUC).
Of the quantitative MRI biomarkers, UTE-MTR had the strongest correlation with both OA Research Society International grade (r=-0.709, P<0.001) and PLM collagen organization score (r=0.579, P<0.001). The UTE-MTR and UTE-AdiabT1ρ values showed significant differences between the normal group and the mild degeneration group (P=0.047 and 0.015, respectively), while UTE-T2* and CubeQuant-T2 did not. The UTE-MTR values were 15.90%±1.06% and 14.59%±1.35% for normal and mildly degenerated cartilage, respectively. The UTE-AdiabT1ρ values were 40.19±2.87 and 42.6±2.26 ms for normal and mildly degenerated cartilage, respectively. ROC analysis showed that UTE-MTR (AUC =0.805, P=0.001, sensitivity =73.7%, specificity =89.5%) had the highest diagnostic efficacy for mild cartilage degeneration, while UTE-AdiabT1ρ (AUC =0.727, P=0.017) and CubeQuant-T2 (AUC =0.712, P=0.026) showed lower diagnostic efficacy.
Quantitative UTE-MT and UTE-AdiabT1ρ biomarkers may potentially be used in the evaluation of early cartilage degeneration.
定量磁共振技术发展迅速，多种磁共振生物标志物已显示出评估关节软骨质量的能力。本研究旨在探讨基于多参数定量超短回波时间（UTE）的磁共振成像在评估人类软骨退变中的诊断效能。
从20例因原发性骨关节炎（OA）行全膝关节置换术的患者（年龄58.8±6.6岁；6例女性）中获取20个新鲜的股骨外侧髁样本。使用基于UTE的磁化传递（UTE-MT）、基于UTE的绝热T1ρ（UTE-AdiabT1ρ）、基于UTE的T2*（UTE-T2*）和CubeQuant-T2序列对样本进行成像。根据国际骨关节炎研究学会分级和偏振光显微镜（PLM）胶原组织评分对软骨退变进行分类。采用Spearman相关分析确定定量磁共振生物标志物[UTE-MT比率（UTE-MTR）、UTE-AdiabT1ρ、UTE-T2*和CubeQuant-T2]、国际骨关节炎研究学会分级和PLM胶原组织评分之间的关系。使用受试者操作特征（ROC）曲线下面积（AUC）评估每种磁共振生物标志物检测轻度软骨退变的诊断效能。
在定量磁共振生物标志物中，UTE-MTR与国际骨关节炎研究学会分级（r=-0.709，P<0.001）和PLM胶原组织评分（r=0.579，P<0.001）的相关性最强。UTE-MTR和UTE-AdiabT1ρ值在正常组和轻度退变组之间存在显著差异（分别为P=0.047和0.015），而UTE-T2*和CubeQuant-T2则无差异。正常和轻度退变软骨的UTE-MTR值分别为15.90%±1.06%和14.59%±1.35%。正常和轻度退变软骨的UTE-AdiabT1ρ值分别为40.19±2.87和42.6±2.26 ms。ROC分析显示，UTE-MTR（AUC=0.805，P=0.001，敏感性=73.7%，特异性=89.5%）对轻度软骨退变的诊断效能最高，而UTE-AdiabT1ρ（AUC=0.727，P=0.017）和CubeQuant-T2（AUC=0.712，P=0.026）的诊断效能较低。
定量UTE-MT和UTE-AdiabT1ρ生物标志物可能潜在地用于早期软骨退变的评估。
