T_(2)依赖性扩散加权MRI对膝关节软骨退变的诊断潜力  

The diagnostic potential of T_(2) dependence in diffusion weighted MRI for the degradation of knee articular cartilage

作　　者：蒋蕾 徐紫薇 罗鹏 李雪峰[1] 左晓勇 李冠武[1] 常时新[1] JIANG Lei;XU Ziwei;LUO Peng;LI Xuefeng;ZUO Xiaoyong;LI Guanwu;CHANG Shixin(Department of Medical Imaging,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Shanghai University of Traditional Chinese Medicine,Shanghai 201200,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院医学影像科,上海200437 [2]上海中医药大学,上海201200

出　　处：《实用放射学杂志》2023年第5期794-797,共4页Journal of Practical Radiology

摘　　要：目的探讨基于T_(2)和扩散加权成像(T_(2)-DWI)2室模型估计的信号分数对早期膝关节软骨退变定量检测的价值。方法采用3.0T MR扫描仪对27例健康对照组[Kellgren-Lawrence分级(K-L)0级]、36例早期膝关节骨性关节炎(OA)(K-LⅠ~Ⅱ级)、27例中期膝关节OA(K-LⅢ级)行膝关节T_(2)-DWI扫描(TE=90、105、120、135、150ms;b值=0、200、400、800、1000、1200s/mm^(2)),产生与每个体素相关联的5×6数据矩列。用Matlab拟合关节软骨中2室信号模型的慢成分信号分数(V_(slow))。采用组内相关系数(ICC)评价观察者内(间)一致性,单因素方差分析3组受试者关节软骨的V_(slow)、表观扩散系数(ADC)和T_(2)值组间差异。采用相关分析软骨V_(slow)值与全器官磁共振成像评分(WORMS)的相关性。绘制受试者工作特征(ROC)曲线分析V_(slow)对早期膝关节OA的诊断效能。结果与健康对照组相比,随关节软骨损伤进程加剧,V_(slow)显著减少,ADC值和T_(2)值呈上升趋势。V_(slow)与软骨WORMS显著相关(rho=-0.804,P<0.001)。V_(slow)诊断早期膝关节OA的曲线下面积(AUC)为0.894,高于ADC、T_(2)及ADC联合T_(2)的AUC(分别为0.773、0.639、0.788),差异有统计学意义。结论基于T_(2)-DWI2室模型的V_(slow)可以区分早期OA和正常关节软骨,并显示出早期OA诊断的潜力。Objective To explore the value of signal scores estimated from a two-compartment model based on T_(2) and diffusion weighted imaging(T_(2)-DWI)for the quantitative detection of early knee articular cartilage degradation.Methods Twenty-seven healthy controls[Kellgren-Lawrence(K-L)0],36 early knee osteoarthritis(OA)(K-LI-I),and 27 moderate kneeOA(K-L I)were scanned with Tr-DWI sequences at 3.0T MR(TE=90,105,120,135,150 ms and b values=0,200,400,800,1000,1200 s/mm^(2)),generating a 5×6 array of data associated with each voxel.The V_(slow) of the two-compartment signal model in articular cartilage was fitted using Matlab.Intra-and inter-observer agreements were evaluated using the intraclass correlation coefficient(ICC).One-way ANOVA was performed to analyze the differences in Vom,apparent diff usion cofficient(ADC)and T_(2) values of articular cartilage among the three groups.Association of cartilage Valow values with w hole-organ magnetic resonance imaging score(WORMS)was assessed by correlation analysis.The diagnostic efficacy of Vsbw for early knee OA was analyzed using receiver operating characteristic(ROC)curves.Results Compared with the healthy control group,V_(slow) significantly decreased with the progression of articular cartilage injury,while ADC and T_(2) values showed an increasing trend.Valow was significantly correlated with cartilage WORMS(rho=-0.804,P<0.001).The area under the curve(AUC)of Valowm for diagnosing early knee OA was 0.894,which was higher than the AUC of ADC,Tr and ADC combined with T_(2)(0.773,0.639 and 0.788,respectively;P<0.05).Conclusion The Valow of the two-compartment model based on T_(2)-DWI can distinguish early OA from normal articular cartilage Valow may be a potential biomarker of early OA.

关 键 词：T_(2)弛豫时间 表观扩散系数 软骨 膝关节骨性关节炎 磁共振成像 

分 类 号：R681.3[医药卫生—骨科学] R445.2[医药卫生—外科学]