Correlation between bone lesion changes and cartilage volume loss in patients with osteoarthritis of the knee as assessed by quantitative magnetic resonance imaging over a 24-month period
Correlation between bone lesion changes and cartilage volume loss in patients with osteoarthritis of the knee as assessed by quantitative magnetic resonance imaging over a 24-month period
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DOI：
10.1136/ard.2007.073023
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发表时间：
2008-05-01
影响因子：
27.4
通讯作者：
Pelletier, J-P
中科院分区：
文献类型：
--
作者：
Raynauld, J-P;Martel-Pelletier, J.;Pelletier, J-P
目的：为了评估膝关节骨关节炎（OA）的患者的骨水肿和囊肿的大小变化超过24个月，并对比这些变化与软骨体积损失使用定量磁共振imaging.Methods：107例膝关节OA，从一个大型试验中选择的双膦酸盐的效果进行了分析，在基线和24个月的磁共振成像。对软骨下骨水肿和囊肿以及软骨体积进行了评估。结果：基线时，86名患者表现出至少一种类型的骨病变：71例水肿、61例囊肿和51例两者兼而有之。在24个月时，虽然没有统计学显著性，但水肿总尺寸变化增加了2.09（SD 15.03）mm，囊肿增加了1.09（8.13）mm;水肿的平均尺寸变化为+0.38（2.18）mm，囊肿为-0.10（4.36）mm。当根据亚区域进行分析时，发现胫骨托（+0.67（2.74）mm，p = 0.02）和胫骨平台外侧（+0.15（0.83）mm，p = 0.09）的囊肿尺寸增加，胫骨平台内侧水肿尺寸增加（+1.73（8.11）mm，p = 0.05）。24个月时，内侧髁（-0.40，p = 0.0001）和内侧胫骨平台（-0.23，p = 0.03）的软骨体积损失和水肿大小变化与内侧髁囊肿大小变化（-0.29，p = 0.01）之间存在显著相关性。多变量分析显示，水肿大小的变化与内侧软骨体积损失（-0.31，p = 0.0004）密切相关。结论：这些数据表明，骨病变是普遍存在于膝关节OA。随着时间的推移，内侧间室的水肿和囊肿大小增加与该区域软骨体积损失更大的相关性强调了软骨下骨病变在OA病理生理学中的重要性。
Objective: To evaluate in patients with knee osteoarthritis (OA) the size changes in bone oedema and cysts over 24 months, and to contrast these changes with cartilage volume loss using quantitative magnetic resonance imaging.Methods: 107 patients with knee OA, selected from a large trial evaluating the effect of a bisphosphonate, were analysed by magnetic resonance imaging at baseline and 24 months. Assessments of subchondral bone oedema and cysts, and cartilage volume were done.Results: At baseline, 86 patients showed the presence of at least one type of bone lesion: 71 oedema, 61 cysts and 51 both. At 24 months, although not statistically significant, the oedema total size change increased by 2.09 (SD 15.03) mm, and the cyst by 1.09 (8.13) mm; mean size change for the oedema was +0.38 (2.18) mm and -0.10 (4.36) mm for the cyst. When analysed according to subregions, an increase was found for the cyst size in the trochlea (+0.67 (2.74) mm, p = 0.02) and in the lateral tibial plateau (+0.15 (0.83) mm, p = 0.09), and for the oedema size in the medial tibial plateau (+1.73 (8.11) mm, p = 0.05). At 24 months, significant correlations were seen between the loss of cartilage volume and oedema size change in the medial condyle (-0.40, p = 0.0001) and the medial tibial plateau (-0.23, p = 0.03), and the changes in cyst size in the medial condyle (-0.29, p = 0.01). A multivariate analysis showed that the oedema size change was strongly and independently associated with medial cartilage volume loss (-0.31, p = 0.0004).Conclusion: These data demonstrate that bone lesions are prevalent in knee OA. The correlation of the oedema and cyst size increase in the medial compartment over time with a greater loss of cartilage volume in this area underlines the importance of subchondral bone lesions in OA pathophysiology.