定量超短回波绝热T_(1)ρ诊断膝关节软骨退变的价值  

Diagnostic value of quantitative ultrashort echo time adiabatic T_(1)ρ imaging in articular cartilage degeneration of the knee joint

作　　者：陈凯 刘晓彤 王一 刘文锋 梁思佩 吴梅 Chen Kai;Liu Xiaotong;Wang Yi;Liu Wenfeng;Liang Sipei;Wu Mei(Department of Radiology,the Second Affiliated Hospital,South China University of Technology,Guangzhou 510180,China;Department of Radiology,Tianhe District Maternal and Child Hospital of Guangzhou,Guangzhou 510610,China)

机构地区：[1]华南理工大学附属第二医院放射科,广州510180 [2]广州市天河区妇幼保健院放射科,广州510610

出　　处：《中华放射学杂志》2024年第12期1424-1430,共7页Chinese Journal of Radiology

基　　金：国家自然科学基金(82372074);广州市科技计划项目(2024A03J1028)。

摘　　要：目的探讨定量超短回波(UTE)绝热T_(1)ρ(AdiabT_(1)ρ)诊断膝关节软骨退变的价值。方法采用前瞻性病例对照研究,2023年3月至2024年9月在华南理工大学附属第二医院和中心大学附属第五医院招募30例健康志愿者和50例骨关节炎(OA)患者。对其单侧膝关节行三维(3D)UTE-AdiabT_(1)ρ序列扫描,圆锥(Cones)数据采集。将膝关节软骨图像逐层划分为13个亚区,共3837个亚区。对每个亚区进行全器官磁共振评分(WORMS),按病变范围分为正常组(WORMS 0分,2589个亚区)、局限性病灶组(WORMS 1、2、2.5分,911个亚区)和弥漫性病灶组(WORMS 3、4、5分,337个亚区);按病变深度分为正常组(WORMS 0分,2589个亚区)、部分软骨层病变组(WORMS 1、2、3、4分,1108个亚区)和全层病变组(WORMS 2.5、5分,140个亚区)。WORMS 1分为早期软骨退变。对受试者膝关节进行Kellgren-Lawrence(KL)分级,分为正常组(KL 0级,1323个亚区)、可疑或轻度OA组(KL 1、2级,1738个亚区)和中度或严重OA组(KL 3、4级,776个亚区)。通过Matlab2017b软件获得每个亚区的UTE-Cones-AdiabT_(1)ρ值和曲线。应用单因素方差分析比较不同WORMS分组和KL分组间UTE-Cones-AdiabT_(1)ρ的差异。采用Spearman相关分析评价UTE-Cones-AdiabT_(1)ρ与WORMS、KL分组的相关性。应用受试者操作特征曲线和曲线下面积(AUC)判定UTE-Cones-AdiabT_(1)ρ诊断早期软骨退变和可疑或轻度OA的效能。结果正常志愿者和OA患者均可以获得良好的软骨图像和拟合度优良的UTE-Cones-AdiabT_(1)ρ曲线。WORMS 0、1、2、2.5、3、4、5分的软骨亚区分别有2589、569、277、65、199、63、75个,UTE-Cones-AdiabT_(1)ρ值分别为(36.1±5.1)、(41.5±5.2)、(42.3±5.3)、(45.2±6.3)、(43.0±5.2)、(44.1±5.4)和(47.5±5.7)ms,差异有统计学意义(F=161.63,P<0.001)。正常组、局限性病灶组和弥漫性病灶组间UTE-Cones-AdiabT_(1)ρ值差异有统计学意义(F=450.92,P<0.001),正常组、部分软骨层病变组和�Objective To investigate the value of quantitative ultrashort-echo-time(UTE)adiabatic T_(1)ρ(AdiabT_(1)ρ)in the diagnosis of articular cartilage degeneration of knee.Methods A prospective case-control study was used.From March 2023 to September 2024,30 healthy volunteers and 50 patients with osteoarthritis(OA)were recruited in the Second Affiliated Hospital,South China University of Technology and the Fifth Affiliated Hospital of Sun Yat-sen University.The unilateral knee joints were scanned by using three-dimensional(3D)UTE-Cones-AdiabT_(1)ρsequence.The articular cartilages of knee were divided into 13 subregions slice by slice,with a total of 3837 subregions.The whole-organ magnetic resonance-imaging score(WORMS)was evaluated in each subregion.According to the extent of lesions,the subregions cartilages were divided into normal group(WORMS 0,2589 subregions),localized lesion group(WORMS 1,2,2.5,911 subregions)and diffuse lesion group(WORMS 3,4,5,337 subregions).According to the depth of lesions,they were divided into normal group(WORMS 0,2589 subregions),partial cartilage layer lesions group(WORMS 1,2,3,4,1108 subregions)and full-thickness lesion group(WORMS 2.5,5,140 subregions).WORMS 1 was early cartilage degeneration.The Kellgren-Lawrence(KL)grade of the knee joints was assessed and divided into normal group(KL grade 0,1323 subregions),suspicious or mild OA group(KL grades 1 and 2,1738 subregions),and moderate or severe OA group(KL grades 3 and 4,776 subregions).The UTE-Cones-AdiabT_(1)ρvalues and curves for each subregion were obtained by Matlab 2017b software.The ANOVA was used to compare the differences in UTE-Cones-AdiabT_(1)ρbetween different WORMS groups and KL groups.Spearman correlation analysis was used to evaluate the correlation between UTE-Cones-AdiabT_(1)ρand WORMS and KL groups.The receiver operating characteristic curve and area under the curve(AUC)were used to determine the efficacy of UTE-Cones-AdiabT_(1)ρin diagnosing early cartilage degeneration and suspicious or mild OA.Results Bot

关 键 词：软骨 关节 磁共振成像 超短回波 绝热T_(1)ρ 

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