Quantitative assessment of cartilage status in osteoarthritis by quantitative magnetic resonance imaging - Technical validation for use in analysis of cartilage volume and further morphologic parameters
Quantitative assessment of cartilage status in osteoarthritis by quantitative magnetic resonance imaging - Technical validation for use in analysis of cartilage volume and further morphologic parameters
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DOI：
10.1002/art.20191
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发表时间：
2004-03-01
影响因子：
--
通讯作者：
Eckstein, F
中科院分区：
文献类型：
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作者：
Graichen, H;Von Eisenhart-Rothe, R;Eckstein, F
Objective.骨关节炎（OA）的定量诊断工具对于评价结构修饰药物的治疗反应非常重要。本研究旨在测试定量磁共振成像（qMRI）的技术有效性（准确性），以可靠地确定总骨界面面积，软骨（裸露）关节表面积的百分比，软骨厚度在OA。在全膝关节置换术前，对21例患者进行了股胫和髌骨软骨的高分辨率MRI检查，采用T1加权梯度回波序列，水激发。在分割原始骨界面区域（在疾病发作之前）和实际软骨层之后，使用专有软件确定软骨关节表面积、软骨厚度和软骨体积的百分比。在手术过程中，髌骨和胫骨内侧和外侧被切除，qMRI获得的结果与通过手术切除组织的表面积、软骨厚度和软骨体积的直接图像分析获得的结果进行比较。结果qMRI和形态学分析结果之间的成对差异为软骨表面积百分比+/- 4.6%，软骨厚度+/- 8.9%，软骨体积+/- 9.1%。相关系数在0.92（厚度）~ 0.98（体积）之间。定量MRI允许技术上准确和鉴别评估OA中侵蚀关节表面积的增加和软骨厚度的减少。这些参数的替代有效性需要在纵向研究中进行检验。当诊断OA、探索其进展或测试对新疗法的反应性时，这些参数可能优于单独测定软骨体积。
Objective. Quantitative diagnostic tools for osteoarthritis (OA) are important for evaluating the treatment response to structure-modifying drugs. This study was undertaken to test the technical validity (accuracy) of quantitative magnetic resonance imaging (qMRI) for reliable determination of the total bone interface area, percentage of cartilaginous (denuded) joint surface area, and cartilage thickness in OA.Methods. High-resolution MRIs of femorotibial and patellar cartilage were acquired in 21 patients prior to total knee arthroplasty, using a T1-weighted gradient-echo sequence with water excitation. After segmentation of original bone interface areas (before disease onset) and the actual cartilage layer, the percentages of cartilaginous joint surface area, cartilage thickness, and cartilage volume were determined using proprietary software. During surgery, the patella and the medial and lateral tibia were resected.Results obtained with qMRI were compared with those obtained by direct image analysis of surface area, cartilage thickness, and cartilage volume of the surgically removed tissue. Results. Pairwise differences between results obtained with qMRI and morphologic analysis were +/- 4.6% for percentage of cartilaginous surface area, +/- 8.9% for cartilage thickness, and +/- 9.1% for cartilage volume. Correlation coefficients ranged from 0.92 (thickness) to 0.98 (volume).Conclusion. Quantitative MRI permits technically accurate and differential assessment of increases in eroded joint surface area and reductions in cartilage thickness in OA. The surrogate validity of these parameters requires testing in longitudinal studies. These parameters may be advantageous over determination of cartilage volume alone when diagnosing OA, exploring its progression, or testing responsiveness to new therapies.