Impact of Sustained Synovitis on Knee Joint Structural Degeneration: 4-Year MRI Data from the Osteoarthritis Initiative
Impact of Sustained Synovitis on Knee Joint Structural Degeneration: 4-Year MRI Data from the Osteoarthritis Initiative
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DOI：
10.1002/jmri.28223
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发表时间：
2022-05-13
影响因子：
4.4
通讯作者：
Joseph, Gabby B.
中科院分区：
文献类型：
--
作者：
Ramezanpour, Sara;Kanthawang, Thanat;Joseph, Gabby B.
背景
滑膜炎症是骨关节炎（OA）的一个风险因素。但到目前为止，关于炎症如何影响膝关节骨关节炎进展的信息有限。
目的
利用半定量磁共振成像（MRI）评分评估持续性滑膜炎对4年内膝关节退行性改变进展的影响。
研究类型
回顾性队列研究。
研究对象
来自骨关节炎倡议（OAI）的249名参与者（其中132名女性[53%]），使用了两种滑膜炎的定义，从而产生了两组在基线、2年和4年随访时均有持续性滑膜炎的参与者（分别为N = 80和N = 132），以及两组在所有三个时间点均无滑膜炎的参与者（分别为N = 81和N = 47）。
磁场强度/序列
3T中等加权（IW）快速自旋回波（TSE）序列和三维（3D）双回波稳态（DESS）序列。
评估
使用前交叉韧带骨关节炎评分（ACLOAS）、MRI膝关节骨关节炎评分（MOAKS）和滑膜增生评分（SPS）对滑膜炎进行半定量评分。使用了两种基于MRI的滑膜炎定义：（i）基于MOAKS和ACLOAS累计评分≥2；（ii）基于ACLOAS、MOAKS和SPS累计评分≥3。使用全器官MRI评分（WORMS）测量从基线到第4年结构异常的变化，并将其定义为结果。
统计检验
针对每种持续性滑膜炎的定义，使用线性回归模型比较有持续性滑膜炎和无持续性滑膜炎的参与者之间WORMS评分纵向变化的差异。
数据结论
与无持续性滑膜炎的个体相比，有持续性滑膜炎的个体观察到结构退行性疾病进展更严重，这表明持续性滑膜炎与进行性骨关节炎有关。
证据级别
3级
技术有效性阶段
2期
对于定义（i），在有滑膜炎的参与者中，髌骨（β系数 = 0.29）和内侧胫骨软骨异常（β系数 = 0.29）的进展率显著更高。对于定义（ii），髌骨（β系数 = 0.36）和内侧股骨软骨（β系数 = 0.30）异常表现出显著差异。
Background Synovial inflammation is a risk factor for osteoarthritis (OA). But to date, there is limited information on how inflammation impacts progression of knee OA. Purpose To investigate how sustained synovitis, assessed with semi-quantitative magnetic resonance imaging (MRI) scores, impacts progression of knee degenerative changes over 4 years. Study Type Retrospective cohort study. Subjects In 249 participants (N = 132 women [53%]), from the Osteoarthritis Initiative (OAI) two definitions for synovitis were used resulting in two groups of participants with sustained synovitis at baseline, 2-year, and 4-year follow-up (N = 80 and N = 132), and two groups without synovitis at all three time points (N = 81 and N = 47). Field Strength/Sequence 3 T intermediate-weighted (IW) turbo spin-echo (TSE) sequence and three-dimensional (3D) dual-echo steady-state (DESS) sequence. Assessment Synovitis was scored semi-quantitatively using the Anterior Cruciate Ligament Osteoarthritis Score (ACLOAS), MRI Osteoarthritis Knee Score (MOAKS), and synovial proliferation score (SPS). Two MRI-based definitions of synovitis were used: (i) score >= 2 based on cumulative score of MOAKS and ACLOAS, and (ii) score >= 3 based on the cumulative score of ACLOAS, MOAKS, and SPS. Changes in structural abnormalities from baseline to year 4 measured using the whole-organ MRI score (WORMS) were defined as outcomes. Statistical Tests Linear regression models were used to compare the differences in longitudinal changes in WORMS scores between participants with and without sustained synovitis for each definition of sustained synovitis. A P-value of Significantly higher rates of progression were found in participants with synovitis for patellar (Beta coeff. = 0.29) and medial tibial cartilage abnormalities (Beta coeff. = 0.29) for definition (i). For definition (ii), patellar (Beta coeff. = 0.36) and medial femoral cartilage (Beta coeff. = 0.30) abnormalities demonstrated significant differences. Data Conclusion Greater progression of structural degenerative disease was observed in individuals with sustained synovitis compared to those without sustained synovitis, suggesting that sustained synovitis is associated with progressive OA. Level of Evidence 3 Technical Efficacy Stage 2