膝骨关节炎患者MRI变化与骨密度的相关性研究

Correlation Between MRI Changes and Bone Mineral Density in Patients with Knee Osteoarthritis

目的:分析探讨膝骨关节炎(KOA)患者软骨损伤、骨髓水肿分别与全身骨密度的关系。方法:选取2023年1月至2023年10月四川省骨科医院收治膝骨关节炎患者90例,均行膝关节MRI及胸部QCT检查。根据QTC结果将患者分为3组:骨密度正常组、骨量减少组、骨质疏松组;同时采集他们的性别、年龄、身体质量指数(BMI)、病程等一般信息。按照Recht关节软骨缺损评分系统、全膝关节磁共振成像评分系统(WORMS)评分分别在膝关节MR上评分,同时收集病例骨密度(BMD),将BMD值与MR软骨缺损评分、骨髓水肿评分做统计学分析。结果:3组的性别、BMI、病程无统计学差异,年龄有统计学差异;3组间的软骨缺损评分及骨髓水肿评分均显示骨量正常组与骨量减少组、骨量正常组与骨质疏松组有统计学意义,骨量减少组与骨质疏松组无统计学意义;KOA软骨损伤与骨密度相关,相关系数r=-0.412;KOA骨髓水肿与骨密度相关,相关系数r=-0.254。结论:KOA患者的全身骨密度值与膝关节软骨损伤、骨髓水肿相关,且全身骨密度减少时,可能提示膝关节软骨损伤程度加重或骨髓水肿程度加重。

Objective:To determine the relationship between cartilage injury,bone marrow edema,and total bone mineral density in patients with knee osteoarthritis(KOA).Methods:Ninety patients with KOA admitted to the Sichuan Province Orthopedic Hospital between March 2023 and October 2023 were selected,all of whom underwent knee joint MRI and chest QCT examinations.The patients were divided into three groups according to the QTC results:normal bone density,reduced bone mass,and osteoporosis.Patient information,such as sex,age,body mass index(BMI),and course of illness,was also obtained.MRIs of the knee joints were scored separately according to the Recht grading and Whole-organ Magnetic Resonance Imaging Score(WORMS).The bone mineral density(BMD)of the patients was calculated and the BMD values were statistically analyzed using the MR score.Results:No statistically significant differences were observed in sex,BMI,or disease duration among the three groups;however,a statistically significant difference was observed in age.The Recht and WORMS scores among the three groups showed statistical significance between the normal bone density group and the reduced bone mass and osteoporosis groups;however,no statistical significance was observed between the reduced bone mass and osteoporosis groups.KOA cartilage injury was negatively correlated with bone density with a correlation coefficient of r=−0.412,while KOA bone marrow edema was negatively correlated with bone density with a correlation coefficient of r=−0.254.Conclusion:The total bone density in patients with KOA is related to knee joint cartilage injury and bone marrow edema.A decrease in total bone density may indicate the severity of knee cartilage injury or bone marrow edema.