膝关节骨性关节炎软骨形态与T2值的MRI对比性分析

Comparative analysis of MRI findings of cartilage morphology and T2 value in knee osteoarthritis

目的:对比分析膝关节骨性关节炎(OA)软骨损伤的MRI形态评分及T2值变化。方法:收集65例膝关节OA病人及10名健康受试者,行膝关节MRI矢状位3D-WATSc、T2 mapping扫描,将病人组分轻度(OA1)组、中度(OA2)组、重度(OA3)组,评价OA组各亚区软骨T2值与全器官磁共振评分法(WORMS)的相关性,比较各亚区T2值在各组间的差异。结果:除股骨外侧区外,OA组软骨T2值与WORMS评分呈正相关(r=0.657~r=0.854,P<0.05);除股骨外侧区T2值外,其余各亚区T2值在各组间差异均有统计学意义(P<0.01);T2值在髌骨区、内侧股骨区、内侧胫骨区发现膝关节OA软骨形态改变前病变的敏感性分别为78.3%、68.2%、54.8%,特异度分别为100%、80%、70%。结论:MRI半定量评价指标WORMS与定量评价指标T2值均能有效评价膝关节OA软骨变化,T2值能够区分膝关节OA软骨损伤程度,发现软骨形态改变前的病变。

Objective:To compare the changes of MRI morphological score and T2 value of cartilage injury in knee osteoarthritis(OA).Methods:Sixty-five knee OA patients and 10 healthy subjects were selected to undergo MRI scanning of sagittal 3D-WATSc and T2 mapping.The patients were divided into mild(OA1),moderate(OA2)and severe(OA3)groups.The correlation between T2 value of cartilage and the whole-organ magnetic resonance imaging score(WORMS)in each sub-region of OA groups was evaluated,and the difference of T2 value in each sub-region among three groups was compared.Results:Except for the lateral region of femoral,T2 values were positively correlated with WORMS scores in OA groups(r=0.657-r=0.854,P<0.05),and the differences of T2 values in other sub-regions were statistically significant(P<0.01).The sensitivity of T2 value in patella,medial region of femoral and medial region of tibia to detect the pre-pathological changes of cartilage morphology of knee OA was 78.3%,68.2%and 54.8%,respectively,and the specificity was 100%,80%and 70%,respectively.Conclusions:Both the MRI semi-quantitative evaluation index WORMS,and the MRI quantitative evaluation index T2 value can effectively evaluate the change of knee OA cartilage.T2 value can differentiate the severity of cartilage injury of knee OA,and discover the cartilage lesions before morphological changes.