Can Signal Abnormalities Detected with MR Imaging in Knee Articular Cartilage Be Used to Predict Development of Morphologic Cartilage Defects? 48-Month Data from the Osteoarthritis Initiative.
Can Signal Abnormalities Detected with MR Imaging in Knee Articular Cartilage Be Used to Predict Development of Morphologic Cartilage Defects? 48-Month Data from the Osteoarthritis Initiative.
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DOI：
10.1148/radiol.2016152308
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发表时间：
2016-05
期刊：
影响因子：
19.7
通讯作者：
B. Schwaiger;A. Gersing;John Mbapte Wamba;M. Nevitt;C. McCulloch;T. Link
中科院分区：
文献类型：
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作者：
B. Schwaiger;A. Gersing;John Mbapte Wamba;M. Nevitt;C. McCulloch;T. Link
目的：比较基线磁共振（MR）成像时信号异常的软骨与基线时无信号异常的关节软骨在48个月内发生形态学关节软骨缺损的发生率。材料和方法所有参与中心的机构审查委员会批准了这项符合HIPAA的研究。来自骨关节炎倡议的90名受试者的右膝（平均年龄，55岁± 8岁[标准差]; 51%的女性）软骨信号异常，但在3.0-T MR成像时没有形态学软骨缺损，并且没有放射学骨关节炎（Kelling-Lawrence评分，0-1）与年龄、性别、Kelling-Lawrence评分，90例受试者（平均年龄，54岁± 5岁; 51%为女性）的右膝关节无任何信号异常或形态学缺陷。中等加权快速自旋回波MR图像上的个体信号异常（n = 126）分为四个亚级：亚级A，低信号;亚级B，不均匀;亚级C，高信号;亚级D，高信号伴肿胀。在房室水平上分析48个月时形态学关节软骨缺损（全器官MR成像评分≥2）的发展，并使用广义估计方程logistic回归模型进行组间比较。结果髌股关节软骨信号异常率高于胫股关节（59.5%比39.5%）。亚级A比亚级C和D更常见（36%比22%）。在基线信号异常的软骨中，48个月时形态学软骨缺损的发生率为57%，而没有基线信号异常的软骨中只有4%在48个月时出现形态学缺损（所有隔室合并和每个隔室单独，P <0.01）。形态学缺陷的发展在任何一个亚级中都没有显著增加（P = 0.98），并且与骨髓异常的进展显著相关（P = 0.002）。结论膝关节软骨MRI信号异常是骨关节炎形态学改变的前兆，可作为评估软骨退变风险的影像学指标。（©）RSNA，2016.
Purpose To determine the incidence with which morphologic articular cartilage defects develop over 48 months in cartilage with signal abnormalities at baseline magnetic resonance (MR) imaging in comparison with the incidence in articular cartilage without signal abnormalities at baseline. Materials and Methods The institutional review boards of all participating centers approved this HIPAA-compliant study. Right knees of 90 subjects from the Osteoarthritis Initiative (mean age, 55 years ± 8 [standard deviation]; 51% women) with cartilage signal abnormalities but without morphologic cartilage defects at 3.0-T MR imaging and without radiographic osteoarthritis (Kellgren-Lawrence score, 0-1) were frequency matched for age, sex, Kellgren-Lawrence score, and body mass index with right knees in 90 subjects without any signal abnormalities or morphologic defects in the articular cartilage (mean age, 54 years ± 5; 51% women). Individual signal abnormalities (n = 126) on intermediate-weighted fast spin-echo MR images were categorized into four subgrades: subgrade A, hypointense; subgrade B, inhomogeneous; subgrade C, hyperintense; and subgrade D, hyperintense with swelling. The development of morphologic articular cartilage defects (Whole-Organ MR Imaging Score ≥2) at 48 months was analyzed on a compartment level and was compared between groups by using generalized estimating equation logistic regression models. Results Cartilage signal abnormalities were more frequent in the patellofemoral joint than in the tibiofemoral joint (59.5% vs 39.5%). Subgrade A was seen more frequently than were subgrades C and D (36% vs 22%). Incidence of morphologic cartilage defects at 48 months was 57% in cartilage with baseline signal abnormalities, while only 4% of compartments without baseline signal abnormalities developed morphologic defects at 48 months (all compartments combined and each compartment separately, P < .01). The development of morphologic defects was not significantly more likely in any of the subgrades (P = .98) and was significantly associated with progression of bone marrow abnormalities (P = .002). Conclusion Knee cartilage signal abnormalities detected with MR imaging are precursors of morphologic defects with osteoarthritis and may serve as imaging biomarkers with which to assess risk for cartilage degeneration. (©) RSNA, 2016.