Kajabi Abdul Wahed, Zbýň Štefan, Smith Jesse S, Hedayati Eisa, Knutsen Karsten, Tollefson Luke V, Homan Morgan, Abbasguliyev Hasan, Takahashi Takashi, Metzger Gregor J, LaPrade Robert F, Ellermann Jutta M
Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, 55455, United States.
Department of Radiology, University of Minnesota, Minneapolis, MN, 55455, United States.
Radiol Adv. 2024 Mar 19;1(1):umae005. doi: 10.1093/radadv/umae005. eCollection 2024 May.
Medial meniscus root tears often lead to knee osteoarthritis. The extent of meniscal tissue changes beyond the localized root tear is unknown.
To evaluate if 7 Tesla 3D T2*-mapping can detect intrasubstance meniscal degeneration in patients with arthroscopically verified medial meniscus posterior root tears (MMPRTs), and assess if tissue changes extend beyond the immediate site of the posterior root tear detected on surface examination by arthroscopy.
In this prospective study we acquired 7 T knee MRIs from patients with MMPRTs and asymptomatic controls. Using a linear mixed model, we compared T2* values between patients and controls, and across different meniscal regions. Patients underwent arthroscopic assessment before MMPRT repair. Changes in pain levels before and after repair were calculated using Knee Injury & Osteoarthritis Outcome Score (KOOS). Pain changes and meniscal extrusion were correlated with T2* using Pearson correlation ().
Twenty patients (mean age 53 ± 8; 16 females) demonstrated significantly higher T2* values across the medial meniscus (anterior horn, posterior body and posterior horn: all <.001; anterior body: =.007), and lateral meniscus anterior (=.024) and posterior (<.001) horns when compared to the corresponding regions in ten matched controls (mean age 53 ± 12; 8 females). Elevated T2* values were inversely correlated with the change in pain levels before and after repair. All patients had medial meniscal extrusion of ≥2 mm. Arthroscopy did not reveal surface abnormalities in 70% of patients (14 out of 20).
Elevated T2* values across both medial and lateral menisci indicate that degenerative changes in patients with MMPRTs extend beyond the immediate vicinity of the posterior root tear. This suggests more widespread meniscal degeneration, often undetected by surface examinations in arthroscopy.
内侧半月板根部撕裂常导致膝关节骨关节炎。局部根部撕裂以外的半月板组织变化程度尚不清楚。
评估7特斯拉3D T2*映射能否检测经关节镜证实的内侧半月板后根撕裂（MMPRT）患者的半月板实质内退变，并评估组织变化是否超出关节镜表面检查所发现的后根撕裂直接部位。
在这项前瞻性研究中，我们采集了MMPRT患者和无症状对照者的7T膝关节MRI。使用线性混合模型，我们比较了患者和对照者之间以及不同半月板区域的T2值。患者在MMPRT修复前接受关节镜评估。使用膝关节损伤与骨关节炎疗效评分（KOOS）计算修复前后疼痛水平的变化。使用Pearson相关性分析疼痛变化和半月板挤出与T2的相关性。
20例患者（平均年龄53±8岁；16例女性）在内侧半月板（前角、后体和后角：均P<.001；前体：P=.007）以及外侧半月板前角（P=.024）和后角（P<.001）的T2值显著高于10例匹配对照者（平均年龄53±12岁；8例女性）的相应区域。升高的T2值与修复前后疼痛水平的变化呈负相关。所有患者的内侧半月板挤出均≥2mm。关节镜检查未发现70%的患者（20例中的14例）有表面异常。
内侧和外侧半月板T2*值升高表明MMPRT患者的退变变化超出了后根撕裂的直接邻近区域。这表明半月板退变更为广泛，在关节镜表面检查中常常未被发现。
