目的 探讨膝骨关节炎(knee osteoarthritis,KOA)患者髌下脂肪垫(infrapatellar fat pad,IPFP)脂肪分数(fat fraction,FF)及T2值与KOA程度之间的关系.材料与方法 前瞻性招募同日行膝关节X线和MRI检查的受检者(男34例,女65例),依据膝关节X线Kellgren-Lawrence分级(KLG)将受检者分成无KOA组(KLG 0～1级)、轻度KOA组(KLG 2级)和重度KOA组(KLG 3～4级)三组.应用3.0 T MR非对称回波的最小二乘估算法迭代水脂分离(iteraterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation,IDEAL-IQ)、T2 mapping技术测量IPFP的FF及T2值,采用Pearson或Spearman相关性分析FF值及T2值与KOA程度的相关性;采用受试者工作特征(receiver operating characteristic,ROC)曲线评估其对KOA的诊断性能.结果 随着KOA程度进展,IPFP的FF值相应越低,T2值越高.无KOA、重度KOA和轻度KOA三组间FF及T2值差异显著,三组的FF值分别为73.13％±3.98％,67.42％±2.25％,61.92％±3.24％,T2值分别为81.04(79.61,82.44)ms,82.72(81.44,84.46)ms,86.79(85.32,89.12)ms,两两组间比较均具有统计学意义(P<0.001).IPFP FF值与KLG呈负相关(r=-0.779),T2值与KLG之间呈正相关(r=0.688).应用FF值及T2值诊断有无KOA的曲线下面积(area under the curve,AUC)分别为0.937、0.837,敏感度分别为71.8％、70.0％,特异度分别为91.7％、82.1％.结论 IPFP的FF值及T2值与KOA严重程度相关,可以在一定程度上反映IPFP的病理生理改变,有望作为KOA新的评估手段.
Study on the correlation between infrapatellar fat pad IDEAL-IQ and T2 mapping sequences and the severity of knee osteoarthritis
Objective:To investigate the relationship between the fat fraction (FF) and T2 values of the infrapatellar fat pad (IPFP) and the severity of knee osteoarthritis (KOA) in patients. Materials and Methods:Prospective recruitment included 99 participants (34 males,65 females) who underwent knee joint X-ray and MRI on the same day. Participants were categorized into three groups based on knee joint X-ray Kellgren-Lawrence grading (KLG):no KOA group (KLG 0-1),mild KOA group (KLG 2),and severe KOA group (KLG 3-4). The FF and T2 values of the IPFP were measured using 3.0 T MR iteraterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation (IDEAL-IQ) and T2 mapping techniques,and employed Pearson or Spearman correlation analysis to examine the relationship between FF values,T2 values,and the severity of KOA. The diagnostic performance of FF and T2 values for KOA was evaluated using receiver operating characteristic (ROC) curves. Results:As the severity of KOA progressed,the FF of the IPFP decreased correspondingly,and the T2 values increased. There were significant differences in FF and T2 values among the no KOA,severe KOA,and mild KOA groups,with FF values of 73.13％±3.98％,67.42％±2.25％,and 61.92％±3.24％,and T2 values of 81.04 (79.61,82.44) ms,82.72 (81.44,84.46) ms,and 86.79 (85.32,89.12) ms,respectively (all P<0.001). The FF values were negatively correlated with KLG (r=-0.779),while the T2 values were positively correlated with KLG (r=0.688). The area under the curve (AUC) for diagnosing the presence of KOA using FF and T2 values was 0.937 and 0.837,with sensitivities of 71.8％ and 70.0％,and specificities of 91.7％ and 82.1％,respectively. Conclusions:Changes in FF and T2 values of the IPFP can to some extent reflect the pathophysiological changes of the IPFP and are related to the severity of KOA,providing new methods for the evaluation of KOA.
国家科技期刊平台
NSTL
万方数据
