Drapé J L, Pessis E, Auleley G R, Chevrot A, Dougados M, Ayral X
Department of Radiology, Hôpital Cochin, Paris, France.
Radiology. 1998 Jul;208(1):49-55. doi: 10.1148/radiology.208.1.9646792.
To determine the validity and the reliability of T1-weighted three-dimensional gradient-echo magnetic resonance (MR) imaging for quantification of articular cartilage abnormalities of osteoarthritic knees.
Forty-three patients (mean age, 63 years) with knee osteoarthritis (American College of Rheumatology criteria) of the medial tibiofemoral compartment underwent a prospective, cross-sectional study. Knees were examined with a T1-weighted three-dimensional gradient-echo sequence (1.4-mm contiguous sections), with use of a 0.2-T dedicated MR unit, before arthroscopic exploration. The tibiofemoral articular cartilage abnormalities were quantified blindly on both the MR and arthroscopic images with the French Society of Arthroscopy (SFA) score (0-100) and grading scheme (five grades).
There was a statistically significant correlation between the SFA-arthroscopic score and the SFA-MR score (r = .83) and between the SFA-arthroscopic grade and the SFA-MR grade (weighted kappa = 0.84). The deepest cartilage lesions graded with arthroscopy and MR imaging showed correlation in the medial femoral condyle (weighted kappa = 0.83) and in the medial tibial plateau (weighted kappa = 0.84). The intraobserver reliability of the SFA-MR score was higher (r = .94) than the interobserver reliability (r = .80).
Quantification of chondropathy with MR imaging is feasible and well correlated with anatomic cartilage breakdown.
确定T1加权三维梯度回波磁共振(MR)成像在量化骨关节炎膝关节软骨异常方面的有效性和可靠性。
对43例(平均年龄63岁)符合美国风湿病学会标准的内侧胫股关节膝关节骨关节炎患者进行了一项前瞻性横断面研究。在关节镜检查前,使用0.2-T专用MR设备,采用T1加权三维梯度回波序列(1.4毫米连续层面)对膝关节进行检查。根据法国关节镜学会(SFA)评分(0-100)和分级方案(五个等级),在MR图像和关节镜图像上对胫股关节软骨异常进行盲法量化。
SFA关节镜评分与SFA-MR评分之间存在统计学显著相关性(r = 0.83),SFA关节镜分级与SFA-MR分级之间也存在相关性(加权kappa = 0.84)。关节镜检查和MR成像分级的最深软骨损伤在内侧股骨髁(加权kappa = 0.83)和内侧胫骨平台(加权kappa = 0.84)显示出相关性。SFA-MR评分的观察者内可靠性(r = 0.94)高于观察者间可靠性(r = 0.80)。
利用MR成像对软骨病进行量化是可行的,且与解剖学软骨破坏密切相关。