Clinical value of weight-bearing CT and radiographs for detecting patellofemoral cartilage visualized by MRI in the MOST study.
Clinical value of weight-bearing CT and radiographs for detecting patellofemoral cartilage visualized by MRI in the MOST study.
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DOI：
10.1016/j.joca.2021.07.011
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发表时间：
2021-11
影响因子：
7
通讯作者：
Nevitt MC
中科院分区：
文献类型：
--
作者：
Segal NA;Murphy MT;Everist BM;Brown KD;He J;Lynch JA;Nevitt MC
髌股关节经常受到骨关节炎（PFOA）的影响，在X线片（XR）上成像不完全。承重CT（WBCT）可提供可视化优势。本研究确定了轴向WBCT和侧位XR检测PFOA特征的灵敏度、特异性和准确性，并与MRI上的软骨损伤进行了比较。对来自MOST队列的60例右膝关节的便利样本进行了分析。由两名经验丰富的肌肉骨骼放射科医生（对受试者不知情）读取WBCT和XR的OARSI JSN评分和MRI的MOAKS软骨评分。以MRI上MOAKS评分为参考标准，比较WBCT和XR髌股OARSI JSN评分的敏感性、特异性和准确性。结果：纳入的参与者（66.7%为女性）的平均±SD年龄和BMI分别为67.6±9.8岁和30.0±5.3 kg/m2。对于除外侧全层软骨丢失外的所有参数，WBCT显示出显著更高的灵敏度（WBCT为0.85-0.97，XR为0.47-0.57）和准确度（WBCT为0.85-0.92，XR为0.48-0.57）（McNemar检验p值均<0.001）。WBCT和XR的PFOA结果分别与MRI上PF软骨的半定量评分之间存在中度至重度和低度至中度一致性。XR JSN [加权kappa=0.83（0.64，1.0）]、WBCT JSN [kappa=0.60（0.48，0.72）]和MRI MOAKS-CM [kappa=0.70（0.61，0.79）]读数的评定者间可靠性良好。WBCT在识别PFOA方面的灵敏度和准确性明显高于X线片。鉴于与XR相同的相对辐射水平和更好的可视化，WBCT有望提高对负重髌股关节的理解。
The patellofemoral joint is frequently affected by osteoarthritis (PFOA) and is incompletely imaged on radiographs (XR). Weight-Bearing CT (WBCT) could offer advantages for visualization. This study determined the sensitivity, specificity, and accuracy of axial WBCT and lateral XR for detection of PFOA features in comparison with cartilage damage on MRI. A convenience sample of 60 right knees from the MOST cohort were analyzed. WBCT and XR were read for OARSI JSN score and MRI for MOAKS cartilage score by two experienced musculoskeletal radiologists blinded to participant. Using MOAKS scoring on MRI (referent standard), the sensitivity, specificity and accuracy of patellofemoral OARSI JSN scores based on WBCT and XR were compared. Results: The mean±SD age and BMI for the participants included (66.7% women) were 67.6±9.8 years and 30.0±5.3 kg/m2 respectively. WBCT demonstrated significantly greater sensitivity (0.85–0.97 on WBCT vs. 0.47–0.57 on XR) and accuracy (0.85–0.92 on WBCT vs. 0.48–0.57 on XR) for all parameters except lateral full-thickness cartilage loss (McNemar’s test p-values all <0.001). There was moderate-to-strong and low-to-moderate agreement between PFOA findings on WBCT and XR, respectively, and semi-quantitative scores of PF cartilage on MRI. Inter-rater reliability for XR JSN [weighted kappa=0.83 (0.64, 1.0)], WBCT JSN [kappa=0.60 (0.48, 0.72)] and MRI MOAKS-CM [kappa=0.70 (0.61, 0.79)] readings were good. WBCT demonstrates significantly greater sensitivity and accuracy than radiographs for identification of PFOA. Given the same Relative Radiation Level as XR and improved visualization, WBCT holds promise to improve understanding of the weight-bearing patellofemoral joint.
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影响因子：
5.5
作者：
Duncan, R. C.;Hay, E. M.;Croft, P. R.
通讯作者：
Croft, P. R.
影响因子：
--
作者：
LaValley, MP;McLaughlin, S;Felson, DT
通讯作者：
Felson, DT
DOI：
10.1002/jor.21253
发表时间：
2011-03
期刊：
Journal of orthopaedic research : official publication of the Orthopaedic Research Society
影响因子：
--
作者：
Draper CE;Besier TF;Fredericson M;Santos JM;Beaupre GS;Delp SL;Gold GE
通讯作者：
Gold GE
影响因子：
2.7
作者：
Bhattacharya, R. ;;Kumar, V.;Hui, A. C.
通讯作者：
Hui, A. C.
影响因子：
7
作者：
Galli, M;De Santis, V;Tafuro, L
通讯作者：
Tafuro, L