膝关节骨关节炎关节软骨T2 Mapping成像
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摘要
目的①总结健康人膝关节软骨T2值的特点。②基于MRI划分的软骨严重程度,探讨T2Mapping在膝关节骨关节炎关节软骨成像的运用。
材料与方法对77例健康人(H)和72例膝关节骨关节炎患者(OA)的膝关节进行临床WOMAC评分和胫股关节软骨矢状位T2Mapping成像,测量软骨10个亚区的全层T2值。OA组另行矢状位FS-3D-FSPGR成像和修订的WORMS评分,按修订的MRRecht分级分成轻度(OA1)和重度(OA2)两组。比较：①T2值在H1(20岁-39岁)和H2(40岁-59岁)组间,H2、OA1和OA2组间,各亚区间及性别间的差异；②T2值与年龄、BMI、WORMS及WOMAC的相关性；③T2值测量的观察者内和观察者间信度。
结果T2值在H2组各亚区(除LFp)均高于H1组(P<0.05),在OA2组的4个亚区(MTa、MFc、MTc和LTc)高于H2组和/或OA1组(P<0.05)。H组T2值在亚区间存在显著性差异(P=0.000),但在性别间无差异。T2值在OA组各亚区(除LFp)与WORMS呈正相关(P<0.01)；在H2组6各亚区与年龄呈正相关(P=0.004-0.015,R值=0.376-0.437)；与BMI及WOMAC无关。T2值测量的观察者内和观察者间信度在H组和OA组(除LTa)普遍较好(P<0.015,R>0.700)。
结论T2Mapping能区分基于MRI的OA严重程度,是膝关节OA病情监测的敏感手段。
Objective:①To summarize the characteristics of T2values in healthy knee articular cartilage;②To evaluate T2Mapping of articular cartilage in knee osteoarthritis (OA) based on MRI severity assessment.
Materials and Methods:One hundred and forty-nine subjects were assessed with WOMAC Index:77healthy (H) and72OA tibiofemoral articular cartilages categorized into OA1and OA2, based on the modified MR Recht Grading System. T2Mapping was performed to calculate the bulk T2values in10subregions, while FS-3D-FSPGR only in OA to obtain the modified WORMS scores. We compared:①the differences of T2values between H1(20-39years) and H2(40-59years); among H2, OA1and OA2; among subregions and between genders;②correlations of T2values with age, BMI, WORMS scores and WOMAC index respectively;③the intra-observer and inter-observer reproducibility of T2values measurement.
Results:T2values of H2were significantly higher than H1(P<0.05, except LFp), the differences of T2values among H2, OA1and OA2in4subregions (MTa, MFc, MTc and LTc) and among subregions within group were significant (P<0.05), but no significance was found between genders. There was positive correlation of T2values with WORMS scores (P<0.01, except LFp), and with age in6subregions of H2(P=0.004-0.015, R=0.376-0.437), but not with BMI nor WOMAC index. The correlation coefficients for intra-observer and inter-observer reproducibility in H and OA (except LTa) were>0.700(P≤0.015).
Conclusion:T2Mapping can differentiate the OA severity of knee cartilage assessed by MRI, and is sensitive to monitoring severity.
材料与方法对77例健康人(H)和72例膝关节骨关节炎患者(OA)的膝关节进行临床WOMAC评分和胫股关节软骨矢状位T2Mapping成像,测量软骨10个亚区的全层T2值。OA组另行矢状位FS-3D-FSPGR成像和修订的WORMS评分,按修订的MRRecht分级分成轻度(OA1)和重度(OA2)两组。比较：①T2值在H1(20岁-39岁)和H2(40岁-59岁)组间,H2、OA1和OA2组间,各亚区间及性别间的差异；②T2值与年龄、BMI、WORMS及WOMAC的相关性；③T2值测量的观察者内和观察者间信度。
结果T2值在H2组各亚区(除LFp)均高于H1组(P<0.05),在OA2组的4个亚区(MTa、MFc、MTc和LTc)高于H2组和/或OA1组(P<0.05)。H组T2值在亚区间存在显著性差异(P=0.000),但在性别间无差异。T2值在OA组各亚区(除LFp)与WORMS呈正相关(P<0.01)；在H2组6各亚区与年龄呈正相关(P=0.004-0.015,R值=0.376-0.437)；与BMI及WOMAC无关。T2值测量的观察者内和观察者间信度在H组和OA组(除LTa)普遍较好(P<0.015,R>0.700)。
结论T2Mapping能区分基于MRI的OA严重程度,是膝关节OA病情监测的敏感手段。
Objective:①To summarize the characteristics of T2values in healthy knee articular cartilage;②To evaluate T2Mapping of articular cartilage in knee osteoarthritis (OA) based on MRI severity assessment.
Materials and Methods:One hundred and forty-nine subjects were assessed with WOMAC Index:77healthy (H) and72OA tibiofemoral articular cartilages categorized into OA1and OA2, based on the modified MR Recht Grading System. T2Mapping was performed to calculate the bulk T2values in10subregions, while FS-3D-FSPGR only in OA to obtain the modified WORMS scores. We compared:①the differences of T2values between H1(20-39years) and H2(40-59years); among H2, OA1and OA2; among subregions and between genders;②correlations of T2values with age, BMI, WORMS scores and WOMAC index respectively;③the intra-observer and inter-observer reproducibility of T2values measurement.
Results:T2values of H2were significantly higher than H1(P<0.05, except LFp), the differences of T2values among H2, OA1and OA2in4subregions (MTa, MFc, MTc and LTc) and among subregions within group were significant (P<0.05), but no significance was found between genders. There was positive correlation of T2values with WORMS scores (P<0.01, except LFp), and with age in6subregions of H2(P=0.004-0.015, R=0.376-0.437), but not with BMI nor WOMAC index. The correlation coefficients for intra-observer and inter-observer reproducibility in H and OA (except LTa) were>0.700(P≤0.015).
Conclusion:T2Mapping can differentiate the OA severity of knee cartilage assessed by MRI, and is sensitive to monitoring severity.
引文
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