Subchondral Cystlike Lesions Develop Longitudinally in Areas of Bone Marrow Edema-like Lesions in Patients with or at Risk for Knee Osteoarthritis: Detection with MR Imaging-The MOST Study
Subchondral Cystlike Lesions Develop Longitudinally in Areas of Bone Marrow Edema-like Lesions in Patients with or at Risk for Knee Osteoarthritis: Detection with MR Imaging-The MOST Study
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DOI：
10.1148/radiol.10091467
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发表时间：
2010-09-01
期刊：
影响因子：
19.7
通讯作者：
Guermazi, Ali
中科院分区：
文献类型：
--
作者：
Crema, Michel D.;Roemer, Frank W.;Guermazi, Ali
目的：评估普遍的骨髓水肿样病变（BMLs）和全层软骨损失与膝关节软骨下囊肿样病变（SCs）的关系，以评估SC形成的骨挫伤与滑液侵入理论。材料和方法：多中心骨关节炎研究是一项对患有或有患膝骨关节炎风险的个体的纵向研究。所有参与中心的机构审查委员会批准了符合hipaa的方案，并获得了所有参与者的书面知情同意。在基线和随访30个月时获取磁共振图像，并使用全器官磁共振成像评分系统进行半定量读取。胫骨股骨关节和髌骨股骨关节被细分为14个亚区。bml和SCs评分为0 ~ 3分。软骨形态评分为0 ~ 6分。通过对两个预测因子进行相互调整的logistic回归，评估了同一次区域流行的BMLs和全层软骨损失与sc的关联。结果：共纳入1283个膝关节。在对全层软骨损失进行调整后，同一亚区域中普遍存在的骨髓瘤与sc的发生率有很强且显著的关联，比值比为12.9（95%可信区间[CI]: 8.9, 18.6）。调整BMLs后，普遍存在的全层软骨损失与同一次区域发生的SCs有显著但不那么重要的关联（优势比为1.4;95% CI: 1.0, 2.0）。基线时全层软骨损失的严重程度与sc的发生没有明显的关系。结论：即使在调整了全层软骨损失后，流行的BMLs也能强烈预测同一亚区发生的SC，这支持了SC形成的骨挫伤理论。(c) rsna, 2010
Purpose: To assess the association of prevalent bone marrow edema-like lesions (BMLs) and full-thickness cartilage loss with incident subchondral cyst-like lesions (SCs) in the knee to evaluate the bone contusion versus synovial fluid intrusion theories of SC formation.Materials and Methods: The Multicenter Osteoarthritis study is a longitudinal study of individuals who have or are at risk for knee osteoarthritis. The HIPAA-compliant protocol was approved by the institutional review boards of all participating centers, and written informed consent was obtained from all participants. Magnetic resonance images were acquired at baseline and 30-month follow-up and read semiquantitatively by using the Whole-Organ Magnetic Resonance Imaging Score system. The tibiofemoral and patellofemoral joints were subdivided into 14 subregions. BMLs and SCs were scored from 0 to 3. Cartilage morphology was scored from 0 to 6. The association of prevalent BMLs and full-thickness cartilage loss with incident SCs in the same subregion was assessed by using logistic regression with mutual adjustment for both predictors.Results: A total of 1283 knees were included. After adjustment for full-thickness cartilage loss, prevalent BMLs showed a strong and significant association with incident SCs in the same subregion, with an odds ratio of 12.9 (95% confidence interval [CI]: 8.9, 18.6). After adjustment for BMLs, prevalent full-thickness cartilage loss showed a significant but much less important association with incident SCs in the same subregion (odds ratio, 1.4; 95% CI: 1.0, 2.0). There was no apparent relationship between severity of full-thickness cartilage loss at baseline and incident SCs.Conclusion: Prevalent BMLs strongly predict incident SCs in the same subregion, even after adjustment for full-thickness cartilage loss, which supports the bone contusion theory of SC formation. (C) RSNA, 2010