多b值DWI及T2*mapping成像软骨定量分析技术在诊断KOA中的应用

doi:10.7517/issn.1674-0475.220520

摘要/Abstract

摘要： 本研究探讨3.0T MRI多b值磁共振扩散加权成像（DWI）及T2*mapping成像软骨定量分析技术在膝骨关节炎（KOA）中的应用价值。选取60例KOA患者（92个膝关节）作为观察组，另选取60例同期健康体检者（90个膝关节）作为对照组，均行多b值DWI和T2*mapping序列扫描，获取关节软骨慢速扩散系数（SlowADC值）、快速扩散系数（FastADC值）、T2*值。结果显示，观察组关节软骨内侧和外侧SlowADC值、FastADC值、T2*值高于对照组（P<0.05）；关节软骨内侧和外侧SlowADC值、FastADC值、T2*值与KOA发生、病情程度呈正相关（P<0.05）；关节软骨内侧和外侧SlowADC值、FastADC值、T2*值联合诊断KOA的AUC为0.900，联合评估KOA病情程度的AUC为0.881。多b值DWI及T2*mapping成像软骨定量分析技术可早期评价KOA软骨损伤，并可区别不同时期KOA，对KOA早期诊断及病情评估均具有重要价值。

关键词: 膝骨关节炎, 关节软骨, 多b值磁共振扩散加权成像, T2*mapping, 诊断, 病情评估

Abstract: This paper investigated the value of 3.0T MRI multi-b-value magnetic resonance diffusion-eighted imaging (DWI) and T2*mapping imaging cartilage quantitative analysis techniques in knee osteoarthritis (KOA). 60 patients (92 knees) with KOA were selected as the observation group, and another 60 patients (90 knees) with healthy physical examination at the same period were selected as the control group, and all of them underwent multi-b-value DWI and T2*mapping sequence scanning to obtain articular cartilage slow diffusion coefficient (SlowADC value), fast diffusion coefficient (FastADC value), and T2* value. The results showed in the observation group the articular cartilage medial and lateral SlowADC, FastADC and T2* values were higher than in the control group (P<0.05). The articular cartilage medial and lateral SlowADC, FastADC and T2* values were positively correlated with the occurrence and extent of KOA (P<0.05). The AUC of combined diagnosis of articular cartilage medial and lateral SlowADC, FastADC and T2* values for KOA was 0.900, and the AUC of combined assessment of the extent for KOA was 0.881. Multi-b-value DWI and T2*mapping imaging cartilage quantitative analysis techniques can evaluate KOA cartilage damage early and distinguish different periods of KOA, which are of great value for early diagnosis and condition assessment of KOA.

Key words: knee osteoarthritis, articular cartilage, multi-b-value magnetic resonance diffusion-weighted imaging, T2*mapping, diagnosis, disease assessment

孙伟伟, 黄部发, 李蕾. 多b值DWI及T2*mapping成像软骨定量分析技术在诊断KOA中的应用[J]. 影像科学与光化学, 2022, 40(5): 1241-1246.

SUN Weiwei, HUANG Bufa, LI Lei. Application of Multi-b Value DWI and T2*mapping Imaging Cartilage Quantitative Analysis Technology in Diagnosis of KOA[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(5): 1241-1246.

参考文献

[1] 郭雄飞, 王挺, 汤立新. 膝骨关节炎患者血浆骨硬化蛋白及关节液YKL-40水平变化及其临床意义[J]. 新乡医学院学报, 2020, 37(2):185-188.
[2] Duymus T M, Mutlu S, Dernek B, et al. Choice of intra-articular injection in treatment of knee osteoarthritis:Platelet-rich plasma, hyaluronic acid or ozone options[J]. Knee Surgery, Sports Traumatology, Arthroscopy:Official Journal of the ESSKA, 2017, 25(2):485-492.
[3] 张艳玲, 杨磊, 刘君伟, 等. 温针灸与骨髓间充质干细胞移植对兔膝骨性关节炎模型血清中MMP-1、MMP-13和IL-10表达的影响[J]. 宁夏医学杂志, 2020, 42(12):1057-1060, 前插1.
[4] Eijgenraam S M, Chaudhari A S, Reijman M, et al. Time-saving opportunities in knee osteoarthritis:T2 mapping and structural imaging of the knee using a single 5-min MRI scan[J]. European Journal of Radiology, 2020, 30(4):2231-2240.
[5] 刘俊丽, 鲍鹏程. 3.0T MRI对踝关节外侧韧带损伤患者损伤程度及治疗效果评价意义[J]. 影像科学与光化学, 2021, 39(6):865-870.
[6] 石磊, 于静红, 张晰尧. 膝关节骨性关节炎模型软骨T2-mapping表现与蛋白多糖含量的相关分析[J]. 放射学实践, 2019, 34(12):1375-1379.
[7] 中国中西医结合学会骨伤科专业委员会. 膝骨关节炎中西医结合诊疗指南[J]. 中华医学杂志, 2018, 98(45):3653-3658.
[8] Stausholm M B, Bjordal J M. Neglect of relevant treatment recommendations in the conduct and reporting of a laser therapy knee osteoarthritis trial:Letter to the editor[J]. BMC Musculoskeletal Disorders, 2021, 22(1):71.
[9] 奚婧, 张情, 王丽, 等. 老年膝骨关节炎患者膝关节肌力与骨密度相关性分析[J]. 中国骨质疏松杂志, 2019, 25(6):793-798.
[10] 门广美, 于静红. 磁共振T2*图在膝关节骨性关节炎诊断中的应用研究进展[J]. 疑难病杂志, 2019, 18(2):204-207.
[11] 孙兆男, 王旭超, 徐敏, 等. 磁共振T2 mapping成像评价膝关节骨关节炎软骨损伤的应用价值[J]. 磁共振成像, 2019, 10(9):680-684.
[12] 张新慧, 于静红. 磁共振T2-mapping与DTI序列对膝关节软骨慢性损伤的应用研究[J]. 中国医药导报, 2020, 17(13):93-97.
[13] Cao J H, Feng D G, Wang Y Z, et al. Chinese herbal medicine Du-Huo-Ji-Sheng-decoction for knee osteoarthritis:A protocol for systematic review and meta-analysis[J]. Medicine (Baltimore), 2021, 100(3):e24413.
[14] Liu C L, Liu C, Ren X, et al. Quantitative evaluation of subchondral bone microarchitecture in knee osteoarthritis using 3T MRI[J]. BMC Musculoskeletal Disorders, 2017, 18(1):496.
[15] 王晓丽, 刘晓莹, 谢靖红. 多b值DWI序列ADC值联合肿瘤标志物检测对肝脏良恶性肿瘤诊断中的临床价值[J]. 中国CT和MRI杂志, 2020, 18(1):101-104.
[16] 马小芳, 马立新, 张涛, 等. 3.0T磁共振多b值DWI及T2* mapping定量分析评价膝骨性关节炎的临床研究[J]. 宁夏医学杂志, 2019, 41(3):258-260.
[17] 陈永, 邱富娟, 朱兴旺, 等. 血管翳并非类风湿关节炎的专利:膝骨关节炎血管翳病理形态观察[J]. 南方医科大学学报, 2019, 39(6):747-750.
[18] Ko J Y, Lee M S, Lian W S, et al. MicroRNA-29a counteracts synovitis in knee osteoarthritis pathogenesis by targeting VEGF[J]. Scientific Reports, 2017, 7(1):3584.
[19] 郭彦德. 血管活性肠肽和NF-κB信号通路在骨关节炎中的作用机制[J]. 基因组学与应用生物学, 2020, 39(2):814-821.