Kim Ji Na, Park Hee Jin, Park Jai Hyung, Park Se Jin, Kim Eugene, Lee Yong Taek, Shin Hyunchul
Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Eur J Radiol. 2023 Oct;167:111028. doi: 10.1016/j.ejrad.2023.111028. Epub 2023 Aug 7.
The aim of this study was to evaluate the relationship between the grade of signal change of the pericruciate fat pad (PCFP) and the location and severity of cartilage alterations in the knee on magnetic resonance imaging (MRI).
This retrospective study included 234 patients (M:F = 96:138, mean: 51 years) who underwent knee MRI. Two experienced musculoskeletal radiologists assessed any PCFP alterations (as grades 0-3) and chondral lesions using the modified Outerbridge grade (as grades 0-4). Bone marrow lesions (BMLs), meniscal status, anterior cruciate ligament alterations, and effusion-synovitis were also evaluated on the MRI. The relationships between PCFP alteration and MR findings (including the grade of chondral lesion) were evaluated.
Signal changes in the PCFP were detected in 150 cases by Reader 1 (grade 0, 67 cases; grade 1, 53 cases; grade 2, 21 cases; grade 3, 9 cases) and in 154 cases by Reader 2 (grade 0, 59 cases; grade 1, 61 cases; grade 2, 24 cases; grade 3, 10 cases). The grade of PCFP signal change was statistically significantly correlated with the grade of the chondral lesion of the medial femoral condyle (MFC) (p = 0.029 and p = 0.003, respectively) and the medial tibial plateau (MTP) (p = 0.045, p = 0.002, Readers 1 and 2, respectively). The grade of PCFP signal change was significantly correlated with the grade of the BMLs of the MFC, MTP, and lateral femoral condyle (p < 0.05) for both readers. PCFP alteration was related to effusion-synovitis and tears of the medial meniscus.
The grade of PCFP signal change was correlated with the severity of the cartilage alteration in the medial compartment of the knee joint and was also correlated with BMLs in the medial compartment, medial meniscal tears, and synovitis. Therefore, signal change in the PFCP seen on MRI can be an additional clue of the presence of osteoarthritis in the knee, particularly in the medial compartment.
本研究旨在评估磁共振成像（MRI）中髌下脂肪垫（PCFP）信号改变的程度与膝关节软骨改变的位置及严重程度之间的关系。
这项回顾性研究纳入了234例行膝关节MRI检查的患者（男∶女 = 96∶138，平均年龄51岁）。两名经验丰富的肌肉骨骼放射科医生使用改良的Outerbridge分级（0 - 4级）评估PCFP的任何改变（0 - 3级）和软骨损伤。还在MRI上评估骨髓损伤（BMLs）、半月板状态、前交叉韧带改变以及积液 - 滑膜炎。评估PCFP改变与MRI表现（包括软骨损伤分级）之间的关系。
读者1在150例中检测到PCFP信号改变（0级，67例；1级，53例；2级，21例；3级，9例），读者2在154例中检测到（0级，59例；1级，61例；2级，24例；3级，10例）。PCFP信号改变的程度与股骨内侧髁（MFC）软骨损伤的程度（分别为p = 0.029和p = 0.003）以及胫骨内侧平台（MTP）软骨损伤的程度（读者1和读者2分别为p = 0.045，p = 0.002）在统计学上显著相关。对于两位读者，PCFP信号改变的程度与MFC、MTP和股骨外侧髁的BMLs程度均显著相关（p < 0.05）。PCFP改变与积液 - 滑膜炎以及内侧半月板撕裂有关。
PCFP信号改变的程度与膝关节内侧间室软骨改变的严重程度相关，也与内侧间室的BMLs、内侧半月板撕裂和滑膜炎相关。因此，MRI上所见的PFCP信号改变可能是膝关节骨关节炎存在的额外线索，尤其是在内侧间室。
