Quantitative magnetic resonance imaging evaluation of knee osteoarthritis progression over two years and correlation with clinical symptoms and radiologic changes
Quantitative magnetic resonance imaging evaluation of knee osteoarthritis progression over two years and correlation with clinical symptoms and radiologic changes
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DOI：
10.1002/art.20000
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发表时间：
2004-02-01
影响因子：
--
通讯作者：
Pelletier, JP
中科院分区：
文献类型：
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作者：
Raynauld, JP;Martel-Pelletier, J;Pelletier, JP
目标。目的：利用磁共振成像(MRI)评价骨关节炎(OA)膝关节软骨体积在两年内的变化，并将MRI变化与放射学变化进行相关性分析。32名有症状的膝关节骨性关节炎患者在基线、6个月、12个月、18个月和24个月时进行了膝关节MRI检查。计算软骨体积的损失，并与骨性关节炎的临床变量的变化以及基线时标准化的半屈膝关节X线片进行对比。所有随访点的软骨丢失进展均有统计学意义(P<；0.0001)，6个月时全软骨丢失平均+/-SD为3.8%+/-5.1%，内侧室软骨丢失平均为4.3%+/-6.5%，12个月时为3.6%+/-5.1%和4.2%+/-7.5%，24月时为6.1%+/-7.2%和7.6%±8.6%。判别函数分析确定了两组患者，在两年的研究中进展缓慢的患者(占整体软骨丢失的15%；n=11)。在基线时，与慢进组相比，快进组的女性比例更高(P=0.001.0 5)，活动范围更小(P=0.0 1)，研究膝关节更大的周长和更高的疼痛程度(P=0.0 5)和僵硬，以及更高的身体质量指数。软骨体积的丢失与X线改变之间没有统计学上的相关性。定量MRI可以准确测量膝关节骨性关节炎的进展，并有助于识别病情进展迅速的患者。这些发现表明，MRI可能有助于评估结构修饰剂治疗骨性关节炎的效果。
Objective. To evaluate the change in osteoarthritic (OA) knee cartilage volume over a two-year period with the use of magnetic resonance imaging (MRI) and to correlate the MRI changes with radiologic changes.Methods. Thirty-two patients with symptomatic knee OA underwent MRI of the knee at baseline and at 6, 12, 18, and 24 months. Loss of cartilage volumes were computed and contrasted with changes in clinical variables for OA and with standardized semiflexed knee radiographs at baseline at 1 and 2 years.Results. Progression of cartilage loss at all followup points was statistically significant (P < 0.0001), with a mean +/- SD of 3.8+/-5.1% for global cartilage loss and 4.3+/-6.5% for medial compartment cartilage loss at 6 months, 3.6+/-5.1% and 4.2+/-7.5% at 12 months, and 6.1+/-7.2% and 7.6+/-8.6% at 24 months. Discriminant function analysis identified 2 groups of patients, those who progressed slowly (15% of global cartilage loss; n = 11) over the 2 years of study. At baseline, there was a greater proportion of women (P = 0.001), a lower range of motion (P = 0.01), a greater circumference and higher level of pain (P = 0.05) and stiffness in the study knee, and a higher body mass index in the fast progressor group compared with the slow progressor group. No statistical correlation between loss of cartilage volume and radiographic changes was seen.Conclusion. Quantitative MRI can measure the progression of knee OA precisely and can help to identify patients with rapidly progressing disease. These findings indicate that MRI could be helpful in assessing the effects of treatment with structure-modifying agents in OA.