磁共振mDIXON-Quant技术在评估膝骨关节炎中髌下脂肪垫质子密度脂肪分数改变的价值研究  

The value of the magnetic resonance mDIXON-Quant technique in the assessment of alterations in the proton density fat fraction of the infrapatellar fat pad in knee osteoarthritis

作　　者：赵保根 王晓英 王硕[1] 张玉金 纪刚 张力 ZHAO Baogen;WANG Xiaoying;WANG Shuo;ZHANG Yujin;JI Gang;ZHANG Li(Department of Radiology and Nuclear Medicine,the First Hospital of Hebei Medical University,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第一医院放射与核医学科,石家庄050011

出　　处：《磁共振成像》2024年第10期123-128,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：河北省自然科学基金项目(编号:H2021206093);京津冀基础研究合作专项(编号:H2021206505)。

摘　　要：目的基于磁共振mDIXON-Quant技术分析膝骨关节炎(knee osteoarthritis,KOA)髌下脂肪垫质子密度脂肪分数(proton density fat fraction,PDFF)改变,及其与KOA严重程度的相关性。材料与方法前瞻性招募44例KOA患者,共计对70例膝关节进行磁共振常规序列及mDIXON-Quant序列扫描,测量KOA患者髌下脂肪垫PDFF。膝关节采用全器官磁共振评分(whole-organ magnetic resonance imaging score,WORMS)评估受试KOA严重程度。分析各膝髌下脂肪垫PDFF与WORMS 11个特征独立评分及总评分的相关性。结果髌下脂肪垫PDFF与膝关节WORMS总评分、关节软骨完整性、边缘骨赘、关节面下骨磨损、关节面下骨髓异常、关节面下骨囊肿、内外侧半月板完整性、关节内游离体、关节周围囊肿/滑囊炎、前后交叉韧带完整性、滑膜炎/积液(r=-0.94、-0.85、-0.83、-0.80、-0.72、-0.52、-0.54、-0.39、-0.27、-0.27、-0.24,P均<0.05)WORMS评分均呈负相关性;与内外侧副韧带完整性(r=0.27,P=0.826)WORMS评分无显著相关性。观察者间一致性非常好ICC=0.793(P<0.001),95%可信区间为(0.667~0.875)。结论磁共振mDIXON-Quant技术可以定量评估KOA患者髌下脂肪垫PDFF改变,髌下脂肪垫PDFF随着KOA严重程度进展而下降。髌下脂肪垫PDFF可以作为反映KOA严重程度的客观评价指标。Objective:Analysis of alterations in the proton density fat fraction(PDFF)of the infrapatellar fat pad using magnetic resonance-based mDIXON-Quant technique in patients with knee osteoarthritis(KOA),and its correlation with KOA severity.Materials and Methods:Prospectively recruited 44 patients with KOA,performing conventional MRI and mDIXON-Quant sequence scans on a total of 70 knees,to measure the PDFF of the infrapatellar fat pad in KOA patients.The severity of the subjects'KOA was evaluated using the whole-organ magnetic resonance imaging score(WORMS).The correlation between the PDFF of the infrapatellar fat pad and the independent scores of the 11 features of the WORMS,and the total scores of each knee were analysed.Results:The PDFF of the infrapatellar fat pad was found to be negatively correlated with a number of variables,including the total knee WORMS scores,articular cartilage integrity,marginal osteophytes,subarticular bone attrition,subarticular bone marrow abnormality,subarticular cysts,medial and lateral meniscal integrity,loose bodies,periarticular cysts/bursitis,anterior and posterior cruciate ligament integrity,and synovitis/effusion WORMS(r=−0.94,−0.85,−0.83,−0.80,−0.72,−0.52,−0.54,−0.39,−0.27,−0.27,−0.24,P<0.05).There was no significant correlation with the medial and lateral collateral ligament integrity(r=0.27,P=0.826).The inter-observer agreement was found to be excellent,with an ICC value of 0.793(P<0.001),and a 95%confidence interval of(0.667-0.875).Conclusions:Magnetic resonance mDIXON-Quant technology enables quantitative evaluation of changes in the PDFF of the infrapatellar fat pad in patients with KOA.The PDFF of the infrapatellar fat pad decreases with the progression of KOA severity,suggesting its potential as an objective indicator to reflect the severity of KOA.

关 键 词：膝关节 骨性关节炎 mDIXON-Quant 髌下脂肪垫 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R684.3[医药卫生—诊断学]