膝骨性关节炎合并髌韧带变性的MRI定量研究

Quantitative MRI study on relationship between knee osteoarthritis and patellar ligament degeneration

目的:采用MRI定量T2 mapping技术探讨膝骨性关节炎患者髌韧带是否有改变,以及髌韧带不同区域的T2值是否存在差异。方法:2023年9—10月,招募健康对照组共31个膝关节,轻度骨性关节炎组(WOMAC指数测定,VAS评分<80分)共52个膝关节,重度骨性关节炎组(VAS评分>120分)共37个膝关节。采用定量T2 mapping序列扫描,选取髌韧带最大截面积层面,髌韧带平均分为近端、中间、远端三个区域(PPL、MPL、DPL)。在上述三个区域的中心位置,选取3个面积为1 mm2的感兴趣区,测量出T2值。比较各组髌韧带PPL、MPL、DPL三个测量区域T2值的差异。结果:健康对照组内,PPL、MPL、DPL三个测量区域的T2值差异无统计学意义(P>0.05)。轻度骨性关节炎组内,PPL、MPL、DPL三个测量区域的T2值差异有统计学意义(P<0.05),且MPL的T2值大于PPL及DPL的T2值。重度骨性关节炎组内,PPL、MPL、DPL三个测量区域的T2值差异均无统计学意义(P>0.05)。轻度骨性关节炎组的PPL、MPL、DPL三个测量区域的T2值高于重度骨性关节炎组(P<0.05)。结论:膝骨性关节炎会同时伴发髌韧带变性;髌韧带的变性首先出现在两端,随着膝关节退变的加重,髌韧带不同部位的变性程度最终会趋于一致。

Objective Using MRI T2 mapping technology to investigate whether there are changes in the patellar ligament and whether there are differences in T2 values in different parts of the patellar ligament in patients with knee osteoarthritis(KOA).Methods Establish a healthy control group,31 knee joints;The mild osteoarthritis group(WOMAC index measurement,VAS score<80 points),52 knee joints;The severe osteoarthritis group(VAS score>120),37 knee joints.Using quantitative T2 mapping sequence scanning,the maximum cross-sectional area of the patellar ligament was selected,and the patellar ligament was divided into three regions on average:proximal,middle,and distal(PPL,MPL,DPL).Select three regions of interest(ROI)with an area of 1 mm2 at the center of the above three regions and measure the T2 value.Single factor analysis of variance was used to compare the differences in T2 values between different measurement areas of the patellar ligament in each group.Independent sample t-tests were used to compare the differences in PPL,MPL,and DPL between mild osteoarthritis group and severe osteoarthritis group.Results The T2 values in different measurement areas of the patellar ligament showed statistical differences among the three groups(P<0.05),and there was a difference between the two groups(P<0.05).The T2 values in different measurement areas of the patellar ligament were shown as Healthy control group>mild osteoarthritis group>severe osteoarthritis group.The comparison of T2 values in the three measurement areas of the patellar ligament between mild osteoarthritis group and severe osteoarthritis group showed significant differences(P<0.05),with mild osteoarthritis group>severe osteoarthritis group.Conclusion Knee osteoarthritis can be accompanied by patellar ligament degeneration;The degeneration of the patellar ligament first occurs at both ends;As the degeneration of the knee joint worsens,the degree of degeneration in different parts of the patellar ligament will eventually become consistent.