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超声检查时通过骨皮质的血流信号可作为一项筛查试验,用于检测早期膝关节骨关节炎患者磁共振成像上的骨髓病变。

Blood flow signals through the bone cortex on ultrasonography can be used as a screening test for detecting bone marrow lesions on magnetic resonance imaging in patients with early knee osteoarthritis.

作者信息

Takemoto Naoki, Takata Yasushi, Shima Yosuke, Goshima Kenichi, Shimozaki Kengo, Kimura Mitsuhiro, Kanayama Tomoyuki, Demura Satoru, Nakase Junsuke

机构信息

Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan.

Department of Orthopedic Surgery, KKR Hokuriku Hospital, Kanazawa, Ishikawa, 921-8035, Japan.

出版信息

J Med Ultrason (2001). 2025 Jan;52(1):149-155. doi: 10.1007/s10396-024-01503-2. Epub 2024 Oct 4.

DOI:10.1007/s10396-024-01503-2
PMID:39365403
Abstract

PURPOSE

Blood flow signals (BFSs) through the bone cortex on ultrasonography (US) and bone marrow lesions (BMLs) detected on magnetic resonance imaging (MRI) can be used to assess bone lesions; however, no studies have reported their relationship. Therefore, this study aimed to assess whether BFSs through the bone cortex on US can serve as a screening test for detecting BMLs on MRI in patients with early knee osteoarthritis (OA).

METHODS

This study enrolled patients with knee joint pain who were diagnosed with early knee OA between January 2018 and January 2024. We targeted 77 patients who underwent MRI and in whom the presence or absence of BFSs through the bone cortex was confirmed on US. The association between BFSs and BMLs was evaluated using the chi-square test, and the sensitivity and specificity of BFSs for detecting BMLs on MRI were calculated.

RESULTS

The chi-square test showed that BFSs and BMLs were significantly associated in the femur and tibia (femur: χ [1] = 52.9, p < 0.001; Tibia: χ [1] = 44.8, p < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of BFSs for detecting BMLs on MRI were 85.0%, 96.5%, 89.5%, and 94.8%, respectively, for the femur, and 84.0%, 92.3%, 84.0%, and 92.3%, respectively, for the tibia.

CONCLUSION

BFSs through the bone cortex on US can be used as a screening test for detecting BMLs on MRI in patients with early knee OA.

摘要

目的

超声(US)检测到的穿过骨皮质的血流信号(BFSs)和磁共振成像(MRI)检测到的骨髓病变(BMLs)可用于评估骨病变;然而,尚无研究报道它们之间的关系。因此,本研究旨在评估超声检测到的穿过骨皮质的BFSs是否可作为早期膝关节骨关节炎(OA)患者MRI检测BMLs的筛查试验。

方法

本研究纳入了2018年1月至2024年1月期间被诊断为早期膝关节OA的膝关节疼痛患者。我们选取了77例接受MRI检查且超声证实有或无穿过骨皮质的BFSs的患者。使用卡方检验评估BFSs与BMLs之间的关联,并计算BFSs检测MRI上BMLs的敏感性和特异性。

结果

卡方检验显示,股骨和胫骨的BFSs与BMLs显著相关(股骨:χ[1]=52.9,p<0.001;胫骨:χ[1]=44.8,p<0.001)。BFSs检测MRI上股骨BMLs的敏感性、特异性、阳性预测值和阴性预测值分别为85.0%、96.5%、89.5%和94.8%,胫骨分别为84.0%、92.3%、84.0%和92.3%。

结论

超声检测到的穿过骨皮质的BFSs可作为早期膝关节OA患者MRI检测BMLs的筛查试验。

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本文引用的文献

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Assessment of blood flow around the knee joint in patients with knee osteoarthritis by color Doppler ultrasound.彩色多普勒超声评估膝骨关节炎患者膝关节周围血流。
Eur J Radiol. 2023 Sep;166:111005. doi: 10.1016/j.ejrad.2023.111005. Epub 2023 Jul 22.
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An Update on Clinical Utility of Musculoskeletal Ultrasonography in Knee Osteoarthritis.肌肉骨骼超声在膝骨关节炎中的临床应用进展。
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Prevalence of ultrasound-detected knee synovial abnormalities in a middle-aged and older general population-the Xiangya Osteoarthritis Study.中老年普通人群中超声检测到的膝关节滑膜异常患病率——湘雅骨关节炎研究
Arthritis Res Ther. 2021 Jun 2;23(1):156. doi: 10.1186/s13075-021-02539-2.
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Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee.膝关节骨关节炎的诊断、病理生理学和治疗的最新进展。
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Magnetic resonance imaging assessment of knee osteoarthritis: current and developing new concepts and techniques.磁共振成像评估膝关节骨关节炎:当前和新发展的概念和技术。
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