Detection Algorithm of Knee Osteoarthritis Based on Magnetic Resonance Images

Knee osteoarthritis(OA)is a common disease that impairs knee function and causes pain.Currently,studies on the detection of knee OA mainly focus on X-ray images,but X-ray images are insensitive to the changes in knee OA in the early stage.Since magnetic resonance(MR)imaging can observe the early features of knee OA,the knee OA detection algorithm based on MR image is innovatively proposed to judge whether knee OA is suffered.Firstly,the knee MR images are preprocessed before training,including a region of interest clipping,slice selection,and data augmentation.Then the data set was divided by patient-level and the knee OA was classified by the deep transfer learning method based on the DenseNet201 model.The method divides the training process into two stages.The first stage freezes all the base layers and only trains the weights of the embedding neural networks.The second stage unfreezes part of the base layers and trains the unfrozen base layers and the weights of the embedding neural network.In this step,we design a block-by-block fine-tuning strategy for training based on the dense blocks,which improves detection accuracy.We have conducted training experiments with different depth modules,and the experimental results show that gradually adding more dense blocks in the fine-tuning can make the model obtain better detection performance than only training the embedded neural network layer.We achieve an accuracy of 0.921,a sensitivity of 0.960,a precision of 0.885,a specificity of 0.891,an F1-Score of 0.912,and an MCC of 0.836.The comparative experimental results on the OAI-ZIB dataset show that the proposed method outperforms the other detection methods with the accuracy of 92.1%.

Congenital absence of the lateral meniscus:A case report

BACKGROUND Congenital absence of the menisci is a rare anatomical variation characterized by the absence or underdevelopment of one or both menisci in the knee joint.The menisci are crucial in load distribution,joint stability,and shock absorption.Understanding the clinical presentation,diagnosis,and management of this condition is important for optimal patient care.CASE SUMMARY A 27-year-old male with a long-standing history of knee pain underwent diagnostic arthroscopy,revealing a congenital absence of the meniscus.The patient's clinical findings,imaging results,surgical procedures,and pertinent images are detailed.This case presents a unique aspect with the congenital absence of the meniscus,contributing valuable insights to the literature on rare anatomical anomalies.CONCLUSION This case of congenital absence of the menisci highlights the diagnostic challenges posed by rare anomalies.The diagnostic arthroscopy played a crucial role in identifying the absence of the meniscus and providing an explanation for the patient's persistent knee pain.The case underscores the importance of individualized treatment approaches,including physical therapy,for optimal management of rare meniscal anomalies.Further research is warranted to explore effective management strategies for the aforementioned cases and to expand our knowledge of these rare conditions.

Magnetic resonance imaging markers for early diagnosis of Parkinson's disease

Parkinson＇s disease （PD） is a neurodegenerative disorder characterized by selective and progressive degeneration, as well as loss of dopaminergic neurons in the substantia nigra. In PD, approximately 60-70% of nigrostriatal neurons are degenerated and 80% of content of the striatal dopamine is reduced before the diagnosis can be established according to widely accepted clinical diagnostic criteria. This condition describes a stage of disease called ＂prodromal＂, where non-motor symptoms, such as olfactory dysfunction, constipation, rapid eye movement behaviour disorder, depression, precede motor sign of PD. Detection of prodromal phase of PD is becoming an important goal for determining the prognosis and choosing a suitable treatment strategy. In this review, we present some non-invasive instrumental approaches that could be useful to identify patients in the prodromal phase of PD or in an early clinical phase, when the first motor symptoms begin to be apparent. Conventional magnetic resonance imaging （MRI） and advanced MRI techniques, such as magnetic resonance spectroscopy imaging, diffusion-weighted and diffusion tensor imaging and functional MRI, are useful to differentiate early PD with initial motor symptoms from atypical parkinsonian disorders, thus, making easier early diagnosis. Functional MRI and diffusion tensor imaging techniques can show abnormalities in the olfactory system in prodromal PD.

Histological Findings of Bone Marrow Lesions on Magnetic Resonance Images in Patients with Varus Knee Osteoarthritis

Bone marrow lesions (BMLs) on magnetic resonance (MR) images in knee osteoarthritis patients are considered to predict the severity and progression of the disease. We evaluated the histological findings of BMLs on MR images of the subchondral area of the medial femoral condyle in varus osteoarthritic knees. In 24 patients with varus knee osteoarthritis who underwent total knee arthroplasty (TKA), sagittal T1- and T2-weighted MR images of the affected knee were acquired before TKA. During TKA, resected bone pieces from the distal medial femoral condyle were obtained. Sagittal specimens obtained from the center of the bone pieces were histologically examined. Twenty patients had BMLs. Histological findings of BMLs in the subchondral area showed various features, such as fibrovascular tissue, cyst formation, active bone remodeling with bone formation and bone resorption, and hyaline cartilage. BMLs were not found in four patients;histological findings of these patients showed normal bone marrow tissue with normal-thickness trabeculae. Subchondral bony end plate in knees with BMLs was usually thin or destroyed, while that without BMLs was thick or normal. The condition of the subchondral bony end plate would explain the differences in the severity and progression between patients with or without BMLs.

Diagnostic performance of contrast-enhanced ultrasound and enhanced magnetic resonance for breast nodules

In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound（US）, contrastenhanced US（CEUS）, combined US and CEUS and magnetic resonance imaging（MRI） in detecting focal solid breast lesions. Totally 117 patients with 120 BI-RADS category 4A-5 breast lesions were evaluated by conventional US and CEUS, and MRI, respectively. SonoVue was used as contrast agent in CEUS and injected as an intravenous bolus; nodule scan was performed 4 minutes after bolus injection. A specific sonographic quantification software was used to obtain color-coded maps of perfusion parameters for the investigated lesion, namely the time-intensity curve.The pattern of contrast enhancement and related indexes regarding the time-intensity curve were used to describe the lesions, comparatively with pathological results. Histopathologic examination revealed 46 benign and 74 malignant lesions. Sensitivity, specificity, and accuracy of US in detecting malignant breast lesions were 90.14%, 95.92%, and 92.52%, respectively. Meanwhile, CE-MRI showed sensitivity, specificity, and accuracy of 88.73%, 95.92%, and91.67%, respectively. The area under the ROC curve for combined US and CEUS in discriminating benign from malignant breast lesions was 0.936, while that of MRI was 0.923, with no significant difference between them, as well as among groups. The time-intensity curve of malignant hypervascular fibroadenoma and papillary lesions mostly showed a fast-in/fast-out pattern, with no good correlation between them（kappa 〈0.20）. In conclusion, the combined use of conventional US and CEUS displays good agreement with MRI in differentiating benign from malignant breast lesions.

Three-dimensional reconstructed magnetic resonance scans:Accuracy in identifying and defining knee meniscal tears

AIM To determine whether three-dimensional(3D) reconstruction from conventional magnetic resonance imaging(MRI) is able to accurately detect a meniscal tear, and define the configuration.METHODS Thirty-three patients' 3T MRI scan data were collected and sagittal uni-planar 3D reconstructions performed from the preoperative MRI. There were 24 meniscal tears in 24 patients, and nine controls. All patients had arthroscopic corroboration of MRI findings. Two independent observers prospectively reported on all 33 reconstructions. Meniscal tear presence or absence was noted, and tear configuration subsequently categorised as either radial, bucket-handle, parrot beak, horizontal or complex.RESULTS Identification of control menisci or meniscal tear presence was excellent(Accuracy: observer 1 = 90.9%; observer 2 = 81.8%). Of the tear configurations, bucket handle tears were accurately identified(Accuracy observer 1 and 2 = 80%). The remaining tear configurations were notaccurately discernable.CONCLUSION Uni-planar 3D reconstruction from 3T MRI knee scan sequences are useful in identifying normal menisci and menisci with bucket-handle tears. Advances in MRI sequencing and reconstruction software are awaited for accurate identification of the remaining meniscal tear configurations.

MR Imaging of Knee Osteoarthritis and Correlation of Findings with Reported Patient Pain

Summary： To evaluate lesion detection of MRI in knee joint osteoarthritis in patients with symptoms of pain, the correlation between MRI findings and varying degrees of reported pain was assessed. Twenty-eight patients （31 knees） with osteoarthritis were recruited for this study. The degree of knee pain was assessed by VRS scores. The knees were evaluated by plain film radiograph utilizing Kellgren-Lawrence scores. Multiple MR sequences were performed on a 1.5T MR-system, including sagittal and coronal dual fast spin echo （TRITE 3660/11/120 ms, slice thickness 5 mm）, coronal spin echo T1-weighted （TR/TE 360/9 ms, slice thickness 5 mm）, sagittal fat saturated 3D-spoiled gradient-recalled echo （TR/TE 50/6 ms; slice thickness 1.5 mm; flip angle 40°）, and 3D steady-state free precession （TR/TE 6/2.2 ms; slice thickness 1.6 mm; flip angle 30°） pulse sequences for the purpose of detecting abnormities of cartilage, menisci, the anterior cruciate ligaments, bone marrow edema-like lesions, osteophytes, synovitis, and joint effusions. MR findings were compared with the degree of pain using Fisher exact test with P values less than 0.05 indicating a statistically significant difference. The results showed that, of the 31 knees evaluated, mild pain was reported in 11 and severe pain in the remainder. Kellgren-Lawrence scores of all 31 evaluated OA knees were as follows： grade 1 lesions （n=6）, grade 2 lesions （n=14）, grade 3 lesions （n=8）, and grade 4 lesions （n=3）. Articular cartilaginous defects were found in 37.1% of knees. Abnormalities of the menisci and anterior cruciate ligaments, bone marrow edema-like lesions, osteophytes, synovitis, and joint effusions were detected in 32.3%, 38.7%, 45.2%, 100%, 15.1% and 67.7% of knees, respectively. Of these variables, only the differences in prevalence of joint effusions were significantly different in the mild and severe pain groups （P=0.004）. It is concluded that MRI evaluates the entire joint structure of the osteoarthritic knee, demonstrating abnormalities of the cartilage, menisci, and anterior cruciate ligaments as well as bone marrow edema-like lesions, osteophytes, synovitis, and joint effusions. The difference in pain grading between OA patients reporting mild and severe degrees of pain is related to the presence of joint effusion.

Quantitative T2＊-Mapping of the Knee Using a Spoiled Gradient Echo Sequence at 3 Tesla： Preliminary Results

Purpose： To evaluate a me-vTE-SPGR （multi echo variable TE Spoiled Gradient Echo Sequence） approach for quantitative T2＊ mapping of the ME （menisci）, the PT （patellar tendon）, the ACL （anterior cruciate ligament）, the PCL （posterior cruciate ligament） and to compare the results between normal and pathological tissue of the ME in the knee joint at 3T （3 Tesla）. Methods： Eighteen consecutive knee patients （35.7± 11.6 years） were examined on 3T. In addition to standard morphological MRI, T2＊-maps were derived from a 0.7 mm isotropic me-vTE-SPGR scan. T2＊-values were assessed by two independent observers using an ROI analysis for the ME （4 different regions： posterior and anterior horn of the medial and lateral meniscus）, PT, ACL and PCL. Intra-class correlation between readers was calculated. Results： On morphological MRI, the PT, ACL and PCL were diagnosed as normal in all cases. Degenerative meniscus and meniscal tears were diagnosed in 13 cases and 9 cases, respectively. T2＊-values of the menisci on me-vTE-SPGR scans, in relation to morphological imaging, were normal （N = 50; 6.0 ±0.9 ms）; degenerative meniscus （N = 13; 8.0± 1.6 ms）; meniscal tears （N = 9; 12.9 ±3.9 ms）, with significant differences between all groups （P 〈 0.05）/ significantly higher T2＊-values in degenerative meniscus and meniscal tears. Mean T2＊ relaxation times for the PT, ACL and PCL were 2.9± 0.8 ms, 8.4 ± 1.6 ms and 8.9 ＋ 1.3 ms respectively. Intra-class correlation values between readers for the ME, PT, ACL and PCL were R2 = 0.962, R2 = 0.927, R2 = 0.594 and R2= 0.648, respectively. Conclusion： Isotropic 3D （three-dimensional） me vTE-SPGR imaging is able to quantify T2＊ values of multiple tissues in the knee joint with short T2 relaxation times.

T1ρ/T2 mapping and histopathology of degenerative cartilage in advanced knee osteoarthritis

AIM To investigate whether normal thickness cartilage in osteoarthritic knees demonstrate depletion of proteoglycan or collagen content compared to healthy knees.METHODS Magnetic resonance(MR) images were acquired from5 subjects scheduled for total knee arthroplasty(TKA)(mean age 70 years) and 20 young healthy control subjects without knee pain(mean age 28.9 years). MR images of T1ρ mapping, T2 mapping, and fat suppressed proton-density weighted sequences were obtained.Following TKA each condyle was divided into 4 parts(distal medial, posterior medial, distal lateral, posterior lateral) for cartilage analysis. Twenty specimens(bone and cartilage blocks) were examined. For each joint,the degree and extent of cartilage destruction was determined using the Osteoarthritis Research Society International cartilage histopathology assessment system.In magnetic resonance imaging(MRI) analysis, 2 readers performed cartilage segmentation for T1ρ/T2 values and cartilage thickness measurement.RESULTS Eleven areas in MRI including normal or near normal cartilage thickness were selected. The corresponding histopathological sections demonstrated mild to moderate osteoarthritis(OA). There was no significant difference in cartilage thickness in MRI between control and advanced OA samples [medial distal condyle, P = 0.461;medial posterior condyle(MPC), P = 0.352; lateral distal condyle, P = 0.654; lateral posterior condyle, P = 0.550],suggesting arthritic specimens were morphologically similar to normal or early staged degenerative cartilage.Cartilage T2 and T1ρ values from the MPC were significantly higher among the patients with advanced OA(P= 0.043). For remaining condylar samples there was no statistical difference in T2 and T1ρ values between cases and controls but there was a trend towards higher values in advanced OA patients. CONCLUSION Though cartilage is morphologically normal or near normal, degenerative changes exist in advanced OA patients. These changes can be detected with T2 and T1ρ MRI techniques.

Non-invasive MRI assessment of the articular cartilage in clinical studies and experimental settings

Attrition and eventual loss of articular cartilage are important elements in the pathophysiology of osteoarthritis(OA).Preventing the breakdown of cartilage is believed to be critical to preserve the functional integrity of a joint.Chondral injuries are also common in the knee joint,and many patients benefit from cartilage repair.Magnetic resonance imaging(MRI) and advanced digital post-processing techniques have opened possibilities for in vivo analysis of cartilage morphology,structure,and function in healthy and diseased knee joints.Techniques of semi-quantitative scoring of human knee cartilage pathology and quantitative assessment of human cartilage have been developed.Cartilage thickness and volume have been quantified in humans as well as in small animals.MRI detected cartilage loss has been shown to be more sensitive than radiographs detecting joint space narrowing.It is possible to longitudinally study knee cartilage morphology with enough accuracy to follow the disease-caused changes and also evaluate the therapeutic effects of chondro-protective drugs.There are also several MRI methods that may allow evaluation of the glycosaminoglycan matrix or collagen network of articular car-tilage,and may be more sensitive for the detection of early changes.The clinical relevance of these methods is being validated.With the development of new therapies for OA and cartilage injury,MR images will play an important role in the diagnosis,staging,and evaluation of the effectiveness of these therapies.

Osteonecrosis of both knees in a woman with Crohn's disease

Osteonecrosis is a very rare complication of Crohn’s disease (CD). It is not clear if it is related to corticosteroid therapy or if it occurs as an extraintestinal manifestation of inflammatory bowel disease. We present the case of a patient with CD who presented with osteonecrosis of both knees. A 22 years old woman was diagnosed with CD in April 2012 (Montreal Classification A2L1 + L4B3p). She was started on prednisolone (40 mg/d), azathioprine (100 mg/d) and messalazine (3 g/d). In July 2012, due to active perianal disease, infliximab therapy was initiated. In September 2012, she had a pelvic abscess complicated by peritonitis and an ileal segmental resection and right hemicolectomy were performed. In December 2012 she was diagnosed with bilateral septic arthritis of both knees with walking impairment. She was treated with amoxicillin-clavulanic acid, started a physical rehabilitation program and progressively improved. However, then, bilateral knee pain exacerbated by movement developed. Magnetic resonance imaging showed multiple osseous medullary infarcts in the distal extremity of the femurs, proximal extremity of the tibiae and patellas and no signs of subchondral collapse, which is consistent with osteonecrosis. The patient recovered completely and maintains therapy with azathioprine and messalazine. A review of the literature is also done.

Discoid medial meniscus of both knees:A case report

BACKGROUND Discoid meniscus is a congenital anomaly that typically affects the lateral meniscus.The appearance of the discoid medial meniscus in both knees is extremely rare,with an incidence of only 0.012%.CASE SUMMARY Our patient was a 30-year-old female.Under no obvious predisposing causes,she began to experience pain in both knees,which worsened while walking and squatting.The pain was aggravated after exercise,and joint flexion and extension activities were accompanied by knee snapping.Apley’s test was positive on physical examination,and there was a pressing pain in the medial articular space.Plain radiographs of both knees revealed no obvious abnormalities in the bilateral knee joint space.Partial meniscectomy as well as menisci reformation were performed on both knees under arthroscopy.Under the guidance of rehabilitation,the patient’s range of motion in both knees returned to normal without pain and knee snapping.CONCLUSION This study showed that the clinical manifestations of the discoid medial meniscus injury are identical to those of the conventional medial meniscus injury,and arthroscopic surgery is effective.

Determination of serum biomarkers in osteoarthritis patients：a previous interventional imaging study revisited

To evaluate in an interventional trial on knee osteoarthritis（OA） the level and change of two serum biomarkers and their correlation with imaging parameters.The previously reported interventional OA study（ClinicalTrials.gov：NCT00536302） identified a positive effect of collagen hydrolysate（CH） on cartilage morphology in patients with knee OA using delayed gadolinium enhanced magnetic resonance imaging（dGEMRIC）.It was the objective in this research project to evaluate in an interventional clinical trial on knee OA the level and change of two serum biomarkers and their correlation with imaging parameters.In blood samples of study participants,we determined the concentration of procollagen type II N-terminal propeptide（PIIANP） and aggrecan chondroitin sulfate 846 epitope（CS846） at baseline（BL） and at the follow-up（FU） visits at 24 and 48 weeks.We measured the level and change of biomarker concentrations in both study groups,and the correlation of those changes with changes in dGEMRIC.For the biomarker PIIANP,we observed a significantly greater increase in the CH group（29.9%vs.1.2%at week 24,P =0.001）.For CS846,the mean concentration was lower among the CH treated participants at 24 weeks（78%vs.96%,P= 0.045）.Consistent correlations of changes in biomarkers PIIANP and CS846 with changes of the dGEMRIC score could not be observed.In this study,different changes per treatment group,CH and placebo were seen for dGEMRIC and PIIANP BL to 24 weeks FU,but only weak correlations between changes in dGEMRIC and biochemical markers.

Knee Osteoarthritis Classification Using X-Ray Images Based on Optimal Deep Neural Network

X-Ray knee imaging is widely used to detect knee osteoarthritis due to ease of availability and lesser cost.However,the manual categorization of knee joint disorders is time-consuming,requires an expert person,and is costly.This article proposes a new approach to classifying knee osteoarthritis using deep learning and a whale optimization algorithm.Two pre-trained deep learning models(Efficientnet-b0 and Densenet201)have been employed for the training and feature extraction.Deep transfer learning with fixed hyperparameter values has been employed to train both selected models on the knee X-Ray images.In the next step,fusion is performed using a canonical correlation approach and obtained a feature vector that has more information than the original feature vector.After that,an improved whale optimization algorithm is developed for dimensionality reduction.The selected features are finally passed to the machine learning algorithms such as Fine-Tuned support vector machine(SVM)and neural networks for classification purposes.The experiments of the proposed framework have been conducted on the publicly available dataset and obtained the maximum accuracy of 90.1%.Also,the system is explained using Explainable Artificial Intelligence(XAI)technique called occlusion,and results are compared with recent research.Based on the results compared with recent techniques,it is shown that the proposed method’s accuracy significantly improved.

关节镜下自体骨软骨移植对膝关节局限性软骨损伤的临床疗效评价

目的探讨关节镜下自体骨软骨移植术对膝关节局限性软骨损伤的临床疗效,并以磁共振成像(MRI)检查对疗效进行评价。方法选取2018年6月至2021年6月诊治的100例膝关节局限性软骨损伤患者,按随机数字表法分为研究组和对照组,每组各50例。研究组采取关节镜下自体骨软骨移植术,对照组采取微骨折术治疗。采用MRI评估其手术疗效,并记录其术后膝关节软骨愈合时间;采用Lysholm膝关节功能评分表、国际膝关节文献委员会(IKDC)膝关节评估表,评估患者治疗前后膝关节功能变化;统计患者术后并发症发生率。结果研究组关节软骨愈合优良率98.00%,高于对照组84.00%(P<0.05)。两组术前和术后3个月的Lysholm评分、IKDC评分比较差异无统计学意义(P>0.05);术后6、12、24个月,研究组Lysholm评分、IKDC评分均高于对照组(P<0.05)。两组患者术后均无严重并发症,且并发症发生率差异无统计学意义(P>0.05)。研究组术后膝关节软骨愈合时间短于对照组(P<0.05)。结论关节镜下自体骨软骨移植术对膝关节局限性软骨损伤的远期治疗效果显著,可有效改善患者术后膝关节功能,缩短膝关节软骨愈合时间,安全性高。

传统武术套路训练对大学生武术运动员膝关节软骨影响的T2-mapping功能磁共振成像研究

目的:本研究旨在通过T2-mapping功能磁共振影像学技术对大学生武术运动员膝关节软骨进行定量评估,探究传统武术套路训练对大学生武术运动员膝关节软骨的影响。方法:选取9名年龄介于18~25岁之间的大学生武术运动员作为实验组,同时选取18名普通健康的大学生作为对照组。在相同条件下,对两组分别进行右膝关节的T2-mapping磁共振检查,并将膝关节软骨分为股骨内侧髁、胫骨内侧髁、髌软骨、股骨外侧髁及胫骨外侧髁5个感兴趣区,比较实验组与对照组之间T2值的差异,分析各组膝关节软骨不同感兴趣区T2值的变化。结果:(1)不论性别,实验组和对照组各个膝关节面软骨感兴趣区的T2值均未见显著性差异(P>0.05);(2)男性对照组、女性对照组以及女性实验组的膝关节各感兴趣区T2值两两之间均无统计学差异(P>0.05);(3)男性实验组膝关节股骨外侧髁与胫骨内侧髁、髌软骨的T2值差异具有统计学意义(P<0.05)。结论:T2-mapping技术可通过无创手段定量评估传统武术套路训练对大学生膝关节软骨的影响。在长期传统武术套路训练后,男性大学生武术运动员的膝关节出现了异质性改变,因此在训练过程中应该注意调整方案,以实现针对性保护。

标准冠状位MRI与多平面重建用于评估膝关节前外侧韧带

目的 对比MRI标准冠状位与多平面重建(MPR)图像评估前外侧韧带(ALL)的价值。方法 纳入130例接受膝关节MR检查患者,分别针对标准冠状位MRI及MPR图识别ALL,并将ALL分为完全可见、部分可见及不可见;比较双侧ALL在2种图像中的可见性,并以Kappa检验进行一致性分析。结果 130例中,标准冠状位MRI及MPR图中,左侧ALL分别有93例及83例完全可见、21例及12例部分可见、26例及25例不可见,右侧ALL分别有66例及80例完全可见、29例及15例部分可见、各有35例不可见。双侧ALL在标准冠状位MRI和MPR图中的可见性差异均有统计学意义(P均<0.05)而一致性均极好(Kappa均>0.80)。结论 MPR显示ALL效果较标准冠状位MRI更佳,但在无法满足其扫描条件时,利用标准冠状位MRI也可较准确地评估ALL。

CT与MRI在膝关节软骨损伤分级诊断中的效能分析

目的:探究CT与MRI在膝关节软骨损伤分级诊断中的效能。方法:回顾性选取我院2021年1月-2023年1月收治的80例膝关节软骨损伤患者为研究对象,对所有患者行CT、MRI和关节镜检查,通过关节镜检查的结果,评估二者的分级诊断效能,并比较CT与MRI在膝关节软骨损伤分级诊断中的诊断价值。结果:患者经CT检查诊断的分级结果为Ⅰ级28例,Ⅱ级34例,Ⅲ级及以上18例;经MRI检查诊断的分级结果为Ⅰ级31例,Ⅱ级29例,Ⅲ级及以上20例。与关节镜检查的结果对比,CT的分级诊断准确率为81.25%(65/80),MRI的分级诊断准确率为95.00%(76/80)。MRI检查诊断膝关节软骨损伤患者的Ⅰ级诊断准确率、总准确率要高于CT检查,差异有统计学意义(P<0.05)。结论:CT与MRI均可对膝关节软骨损伤进行分级诊断,但MRI对膝关节软骨损伤分级的诊断准确率高于CT,具有更高的诊断效能。

MRI检查指标、血清骨钙素、MMP-1及IL-1对膝骨关节炎合并软骨损伤的预测价值

目的探讨磁共振成像(MRI)及血清骨钙素、基质金属蛋白酶(MMP-1)及白细胞介素-1(IL-1)对膝骨关节炎合并软骨损伤的预测价值。方法回顾性分析2021年8月至2023年5月广西贵港市人民医院收治的84例膝骨关节炎患者的临床资料。入院后均行关节镜检查,依据检查结果是否合并软骨损伤分组,分为合并组(n=40)与未合并组(n=44)。比较两组资料[性别、年龄、体重指数、合并疾病(高血压、高脂血症、糖尿病)、病变部位(左膝、右膝)、饮酒史、吸烟史]、MRI不同区域软骨T_(2)值[股骨外侧(LF)、股骨内侧(MF)、胫骨外侧(LT)、胫骨内侧(MT)、髌骨区(P)]以及血清骨钙素、MMP-1、IL-1水平。通过多因素采取非条件Logistic逐步回归分析明确膝骨关节炎合并软骨损伤的危险因素。通过受试者操作特征(ROC)曲线分析MRI不同区域软骨T_(2)值、血清骨钙素、MMP-1、IL-1预测膝骨关节炎合并软骨损伤的价值。结果两组性别构成比、年龄、体重指数、病变部位、合并高血压、高脂血症、糖尿病、饮酒史、吸烟史比较,差异均无统计学意义(P>0.05);合并组MRI不同区域软骨T_(2)值以及血清骨钙素、MMP-1、IL-1水平均显著高于未合并组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,MRI不同区域软骨T_(2)值、骨钙素、MMP-1、IL-1是膝骨关节炎患者合并软骨损伤的危险因素(P<0.05)。经ROC分析证实,LF软骨T_(2)值、MF软骨T_(2)值、LT软骨T_(2)值、MT软骨T_(2)值、P软骨T_(2)值、骨钙素、MMP-1、IL-1最佳截断值分别为39.705 ms、44.250 ms、36.855 ms、35.715 ms、38.005 ms、6.655μg/L、7.335μg/L、389.340 pg/mL,曲线下面积分别为0.796、0.840、0.859、0.882、0.728、0.705、0.763、0.721,均有较高预测价值(P<0.05)。结论MRI不同区域软骨T_(2)值、血清骨钙素、MMP-1、IL-1是膝骨关节炎合并软骨损伤的危险因素;同时LF软骨T_(2)值≥39.705 ms、MF软骨T_(2)值≥44.250 ms、LT软骨T_(2)值≥36.855 ms、MT软骨T_(2)值≥35.715 ms、P软骨T_(2)值≥38.005 ms、骨钙素≥6.655μg/L、MMP-1≥7.335μg/L、IL-1≥389.340 pg/mL可用于预测此类患者合并风险。

256层螺旋CT与MRI对膝关节隐性创伤骨折的诊断价值观察

目的 分析256层螺旋CT与磁共振成像(MRI)对膝关节隐性创伤骨折的诊断价值。方法选取2019年11月~2023年11月期间收治的膝关节骨折患者86例,回顾性分析其临床资料。所有患者均实施手术治疗,术前实施256层螺旋CT与MRI检查。分析256层螺旋CT与MRI检查对膝关节隐性创伤骨折的诊断价值。结果86例患者中,共79例患者发生膝关节隐性创伤骨折,其中以胫骨近端、腓骨近端、髌骨、股骨远端出现隐性创伤骨折为主。256层螺旋CT检查诊断中,诊断准确度为93.02%,敏感度为93.67%,特异度为85.71%,Kappa值为0.630。MRI检查诊断中,诊断准确度为94.19%,敏感度为94.94%,特异度为85.71%,Kappa值为0.675。结论256层螺旋CT检查与MRI检查诊断膝关节隐性创伤骨折的诊断价值均较高。