三维超短回波绝热T1ρ对关节软骨退变的定量评估  

Quantitative assessment of three-dimensional ultrashort echo time adiabatic T1ρimaging in articular cartilage degeneration

作　　者：刘文锋[1] 林俊坤 谭彩虹 刘晓彤 陈晓君[4] 杜江 吴梅[1] LIU Wenfeng;LIN Junkun;TAN Caihong;LIU Xiaotong;CHEN Xiaojun;DU Jiang;WU Mei(Department of Radiology,Guangzhou First People's Hospital,Affiliated Second Hospital of South China University of Technology,Guangzhou 510180,China;Department of Imaging,Guangdong Provincial Hospital of Traditional Chinese Medicine Ersha Island Branch,Guangzhou 510100,China;Department of Medical Imaging,Huizhou Hospital of Guangzhou University of Traditional Chinese Medicine,Huizhou 516000,China;Department of Radiology,the Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai 519000,China;Department of Radiology,University of California San Diego,San Diego 92037,USA)

机构地区：[1]广州市第一人民医院(华南理工附属第二医院)放射科,广州510180 [2]广东省中医院二沙岛分院影像科,广州510100 [3]广州中医药大学惠州医院医学影像科,惠州516000 [4]中山大学附属第五医院放射科,珠海519000 [5]美国加州大学圣地亚哥分校放射科,圣地亚哥92037

出　　处：《磁共振成像》2025年第2期88-93,共6页Chinese Journal of Magnetic Resonance Imaging

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

摘　　要：目的应用三维超短回波绝热T1ρ(three dimensional ultrashort echo time adiabatic T1ρ,3D UTE-AdiabT1ρ)定量评估关节软骨的退变,以期完善骨关节炎(osteoarthritis,OA)早期定量评估的磁共振技术方法。材料与方法应用3D UTE-AdiabT1ρ序列圆锥(Cones)数据采集技术对20名健康志愿者和40名不同程度OA患者进行膝关节的扫描。由两名肌骨影像医师在T2WI压脂矢状位图像上把每层膝关节软骨分成13个亚区并进行全器官磁共振评分(Whole-Organ Magnetic-Resonance-Imaging Score,WORMS)。根据WORMS进行分组:WORMS=0为正常软骨组;按病变范围分为局限性病灶组(WORMS=1、2、2.5分)和弥漫性病灶组(WORMS=3、4、5分);按病变深度分为部分软骨层病变组(WORMS=1、2、3、4分)和全层病变组(WORMS=2.5、5分)。应用方差分析和Tukey-Kramer检验进行两两组间比较,分析不同WORMS分组间3D UTE-Cones-AdiabT1ρ值的差异性。应用Spearman's相关分析3D UTE-Cones-AdiabT1ρ及UTE-T1值与WORMS的相关性。应用受试者工作特征(receiver operating characteristic,ROC)曲线判定3D UTE-Cones-AdiabT1ρ诊断早期OA(WORMS=1)的效能,采用DeLong检验比较3D UTE-Cones-AdiabT1ρ、UTE大分子组分(macromolecular fraction,MMF)和磁化传递率(magnetization transfer ratio,MTR)诊断早期OA(WORMS=1)的曲线下面积(area under the curve,AUC)。结果WORMS从0到5分各组的UTE-Cones-AdiabT1ρ值分别为36.6、41.7、42.7、45.0、43.2、44.3、47.9 ms;局限性病灶组的UTE-Cones-AdiabT1ρ值为42.0 ms,弥漫性病灶组的UTE-Cones-AdiabT1ρ值为44.3 ms;部分软骨层病变组的UTE-Cones-AdiabT1ρ值为42.5 ms;全层病变组的UTE-Cones-AdiabT1ρ值为46.9 ms。膝关节软骨病变的WORM评分越高、病变范围越广、病变越深时3D UTE-Cones-AdiabT1ρ值越高,组间差异均有统计学意义(F=159.7,P<0.001;F=423.6,P<0.001;F=466.3,P<0.001)。WORMS=0时不同软骨区域的3D UTE-Cones-AdiabT1ρ值不同。3D UTE-Cones-AdiabT1ρ值与WORM评分、病变范围�Objective:To quantitatively evaluate articular cartilage degeneration using three-dimensional ultrashort-echo-time Adiabatic-T1ρ(3D UTE-AdiabT1ρ)imaging and improve magnetic resonance technique for the early quantitative evaluation of osteoarthritis(OA).Materials and Methods:The knee joint scanning was performed in 20 healthy volunteers and 40 OA patients with different degrees of OA using 3D UTE-AdiabT1ρsequence and Cones data collection.The knee cartilages were divided into 13 subregions slice by slice on sagittal fat suppression images of T2WI and Whole-Organ Magnetic Resonance Imaging Score(WORMS)were performed by two musculoskeletal radiologists.WORMS includes 0,1,2,2.5,3,4,and 5 points.According to the extent of lesions,they were divided into localized lesion group(WORMS=1,2,2.5 points)and diffuse lesion group(WORMS=3,4,5 points).According to the depth of lesions,they were divided into partial layer lesions(WORMS=1,2,3,4 points)and full layer lesions(WORMS=2.5,5 points).The differences in UTE-Cones-AdiabT1ρamong different groups based on WORMS were assessed and compared using one-way analysis of variance(ANOVA)and Tukey-Kramer test.The correlations between UTE-Cones-AdiabT1ρ,UTE-T1 and WORMS were evaluated using Spearman's correlation coefficient.Receiver operating characteristic(ROC)was used to evaluate the diagnostic efficacy of UTE-Cones-AdiabT1ρfor the detection of earl cartilage degeneration(WORMS=1).The DeLong test was used to compare the area under the curve(AUC)of UTE-Cones-AdiabT1ρ,UTE macromolecular fraction(MMF)and magnetization transfer ratio(MTR).Results:The UTE-Cones-AdiabT1ρfrom 0 to 5 points of WORMS were 36.6 ms,41.7 ms,42.7 ms,45.0 ms,43.2 ms,44.3 ms,and 47.9 ms,respectively.UTE-Cones-AdiabT1ρin localized lesion group was 42.0 ms,with 44.3 ms in diffuse lesion group,42.5 ms in partial layer lesions,and 46.9 ms in full layer lesions.The higher UTE-Cones-AdiabT1ρvalues were observed in higher WORMS,also in larger and deeper lesions,and the differences among these groups were statis

关 键 词：骨关节炎 膝关节退行性变 关节软骨退变 磁共振成像 超短回波 绝热T1ρ 定量评估 早期诊断 

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]