Magnetic resonance imaging (MRI) of articular cartilage in knee osteoarthritis (OA): morphological assessment
Magnetic resonance imaging (MRI) of articular cartilage in knee osteoarthritis (OA): morphological assessment
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DOI：
10.1016/j.joca.2006.02.026
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发表时间：
2006-01-01
影响因子：
7
通讯作者：
Peterfy, C.
中科院分区：
文献类型：
--
作者：
Eckstein, F.;Cicuttini, Flavia M.;Peterfy, C.
目的：磁共振成像（MRI）是一种三维成像技术，具有无与伦比的评估关节软骨的能力。本文综述了定量MRI （qMRI）软骨形态学评估的现状，以及其在识别疾病状态、监测膝关节骨性关节炎（OA）进展和治疗反应中的相关性。膝关节骨性关节炎的MRI国际专家小组，在qMRI软骨形态分析方面有直接经验，回顾了现有的已发表和未发表的关于该主题的数据，并在2002年12月，马萨诸塞州贝塞斯达举行的OMERACT-OARSI成像技术研讨会上，与来自学术界、制药行业和监管机构的科学家和临床医生讨论了研究结果。本报告回顾了(1)MRI脉冲序列对关节软骨形态学分析的考虑；(2)软骨分割技术；(3)软骨状态半定量评分；(4)软骨形态定量指标的技术效度（准确性）、精密度（再现性）和对变化的敏感性。结果：软骨状态的半定量评分显示出足够的可靠性、特异性和敏感性，并在合理的观察期（1-2年）检测病变进展。软骨形态定量评估（qMRI），采用脂肪抑制的梯度回波序列，以及适当的图像分析技术，在OA患者的横断面和纵向研究中显示出较高的准确性和足够的精度（例如，胫骨内侧的均方根标准差= 61 μ l）。纵向研究表明，在大多数膝间室CA中，软骨体积每年的变化约为-4%至-6%（例如，胫骨内侧的软骨体积为-90 μ l）。软骨体积的年度变化超过了精度误差，似乎与临床症状以及膝关节置换术的时间有关。结论：MRI提供了膝关节大部分部位软骨状态的可靠和定量数据，现在有了多中心试验的可靠获取方案。软骨MRI在骨性关节炎进展的大规模流行病学研究以及骨性关节炎药物治疗反应的临床试验中具有巨大的潜力。(C) 2006国际骨关节炎研究学会。Elsevier Ltd.出版。版权所有。
Objective: Magnetic resonance imaging (MRI) is a three-dimensional imaging technique with unparalleled ability to evaluate articular cartilage. This report reviews the current status of morphological assessment of cartilage with quantitative MRI (qMRI), and its relevance for identifying disease status, and monitoring progression and treatment response in knee osteoarthritis (OA).Method. An international panel of experts in MRI of knee OA, with direct experience in the analysis of cartilage morphology with qMRI, reviewed the existing published and unpublished data on the subject, and debated the findings at the OMERACT-OARSI Workshop on Imaging technologies (December 2002, Bethesda, MA) with scientists and clinicians from academia, the pharmaceutical industry and the regulatory agencies. This report reviews (1) MRI pulse sequence considerations for morphological analysis of articular cartilage; (2) techniques for segmenting cartilage; (3) semi-quantitative scoring of cartilage status; and (4) technical validity (accuracy), precision (reproducibility) and sensitivity to change of quantitative measures of cartilage morphology.Results: Semi-quantitative scores of cartilage status have been shown to display adequate reliability, specificity and sensitivity, and to detect lesion progression at reasonable observation periods (1-2 years). Quantitative assessment of cartilage morphology (qMRI), with fat-suppressed gradient echo sequences, and appropriate image analysis techniques, displays high accuracy and adequate precision (e.g., root-mean-square standard deviation medial tibia = 61 mu l) for cross-sectional and longitudinal studies in OA patients. Longitudinal studies suggest that changes of cartilage volume of the order of -4% to -6% occur per annum in CA in most knee compartments (e.g., -90 mu l in medial tibia). Annual changes in cartilage volume exceed the precision errors and appear to be associated with clinical symptoms as well as with time to knee arthroplasty.Conclusions: MRI provides reliable and quantitative data on cartilage status throughout most compartments of the knee, with robust acquisition protocols for multi-center trials now being available. MRI of cartilage has tremendous potential for large scale epidemiological studies of CA progression, and for clinical trials of treatment response to structure modifying OA drugs. (C) 2006 OsteoArthritis Research Society International. Published by Elsevier Ltd. All rights reserved.