Nielsen Flemming Kromann, Sørensen Flemming Brandt, Egund Niels, Boel Lene Warner, Holm Carsten, Jurik Anne Grethe
Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.
Department of Pathology, Aarhus University Hospital, Aarhus, Denmark.
Acta Radiol. 2024 Jul;65(7):765-773. doi: 10.1177/02841851241251639. Epub 2024 May 20.
Bone marrow lesions (BMLs) in knee osteoarthritis (OA) have been assessed histopathologically and by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI); however, a direct comparison of the results has not been reported.
To evaluate and compare the findings by DCE-MRI and histopathology of subchondral BMLs in knee OA.
In total, 19 patients with medial tibiofemoral knee OA undergoing total knee arthroplasty were analyzed. Preoperative MRI, including a DCE sequence, was performed, and bone biopsies were obtained from the resected specimens corresponding to BML areas. The contrast enhancement by DCE-MRI was analyzed using semi-quantitative (area under the curve [AUC]), peak enhancement [PE]), and quantitative (Ktrans, Kep) methods. Enhancement in the medial OA compartment was compared with similar areas in a normal lateral compartment, and the DCE characteristics of BMLs were correlated with semi-quantitatively graded histopathological features.
AUC and PE were significantly higher in medial tibial and femoral BMLs compared with the values in the lateral condyles; Ktrans and Kep were only significantly higher in the tibial plateau. In the tibia, AUC and PE were significantly correlated with the grade of vascular proliferation, and PE also with the degree of marrow fibrosis. There was no significant correlation between AUC/PE and histopathological findings in the femur and no correlation between quantitative DCE parameters and histopathological findings.
BML characteristics by semi-quantitative DCE in the form of AUC and PE may be used as parameters for the degree of histopathological vascularization in the bone marrow whereas quantitative DCE data were less conclusive.
膝关节骨关节炎（OA）中的骨髓损伤（BMLs）已通过组织病理学和动态对比增强磁共振成像（DCE-MRI）进行评估；然而，尚未有关于结果直接比较的报道。
评估并比较DCE-MRI和膝关节OA软骨下BMLs组织病理学的研究结果。
共分析了19例接受全膝关节置换术的胫股内侧膝关节OA患者。术前进行了包括DCE序列的MRI检查，并从与BML区域对应的切除标本中获取骨活检。使用半定量（曲线下面积[AUC]、峰值增强[PE]）和定量（Ktrans、Kep）方法分析DCE-MRI的对比增强。将内侧OA间隙的增强与正常外侧间隙的相似区域进行比较，并将BMLs的DCE特征与半定量分级的组织病理学特征相关联。
与外侧髁的值相比，胫股内侧BMLs的AUC和PE显著更高；Ktrans和Kep仅在胫骨平台显著更高。在胫骨中，AUC和PE与血管增生程度显著相关，PE也与骨髓纤维化程度相关。股骨中AUC/PE与组织病理学结果之间无显著相关性，定量DCE参数与组织病理学结果之间也无相关性。
以AUC和PE形式的半定量DCE的BML特征可作为骨髓组织病理学血管化程度的参数，而定性DCE数据的结论性较差。
