软骨多参数磁共振成像对膝骨关节炎诊断及严重程度评估的应用研究OA
Application of cartilage multi-parametric magnetic resonance imaging in the diagnosis and severity assessment of knee osteoarthritis
目的 探讨软骨多参数磁共振成像对膝骨关节炎诊断及严重程度评估的应用价值.方法 选择2023年1月—2024年12月石家庄市第二医院收治的108例膝骨关节炎患者作为观察组,根据Kellgren-Lawrence(K-L)分级标准分为轻度组50例和重度组58例.另选同期健康体检者108例作为对照组.所有入选者均接受软骨多参数磁共振成像检查,比较不同组间T1ρ值、T2值、T2*值及表观扩散系数(ADC),使用受试者工作特征(ROC)曲线分析膝关节软骨T1ρ值、T2值、T2*值、ADC对膝骨关节炎的诊断效能,以Pearson相关性分析膝骨关节炎患者膝关节软骨T1ρ值、T2值、T2*值、ADC与西安大略大学和麦克马斯特大学骨关节炎指数(WOMAC)评分、全器官磁共振成像系统(WORMS)软骨形态评分的关系.结果 观察组软骨T1ρ值、T2值、T2*值、ADC均大于对照组(P＜0.01).经ROC曲线分析,软骨T1ρ值、T2值、T2*值联合ADC诊断膝骨关节炎的敏感度为90.12％、特异度为51.82％、曲线下面积为0.893.重度组软骨T1ρ值、T2值、T2*值、ADC均大于轻度组,WOMAC评分、WORMS软骨形态评分均高于轻度组(P＜0.01).经Pearson相关性分析,膝骨关节炎患者膝关节软骨T1 ρ值、T2值、T2*值、ADC与WOMAC评分、WORMS软骨形态评分呈正相关(P＜0.01).结论 软骨多参数磁共振成像测量的T1ρ值、T2值、T2*值联合ADC对膝骨关节炎的诊断具有一定提示作用,且与膝骨关节炎严重程度相关.
Objective To explore the application value of multiparametric magnetic resonance imaging of cartilage in the diagnosis and severity assessment of knee osteoarthritis(KOA).Methods We selected 108 patients with KOA diagnosed at the Second Hospital of Shijiazhuang City from January 2023 to December 2024 as study subjects(observation group),and divided them into mild group(n=50)and severe group(n=58)according to Kellgren-Lawrence(K-L)grading criteria.Another 108 healthy subjects undergoing physical examination in the same period were selected as control group.All candidates underwent cartilage multiparametric magnetic resonance imaging and the T1ρ value,T2 value,T2*value,and apparent diffusion coefficient(ADC)were compared among different groups.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of knee cartilage T1ρ value,T2 value,T2*value and ADC in KOA.The relationship of T1-ρ value,T2 value,T2*value,ADC,with Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score and the Whole-Organ Magnetic Resonance Imaging Score(WORMS)cartilage morphology score in patients with KOA was analyzed by Pearson correlation.Results The T1ρ value,T2 value,T2*value and ADC of cartilage in observation group were higher than those in control group(P＜0.01).ROC curve analysis showed that the sensitivity,specificity and the area under the curve(AUC)of T1-ρ value,cartilage T2 value and T2*value combined with ADC for the diagnosis of KOA were 90.12％,51.82％and 0.893,respectively.The T1-ρ value,T2 value,T2*value and ADC of cartilage in severe group were higher than those in mild group(P＜0.01),and the WOMAC score and WORMS cartilage morphology score in severe group were higher than those in mild group(P＜0.01).By Pearson correlation analysis,T1-ρ value,T2 value,T2*value and ADC of knee cartilage in patients with KOA were positively correlated with WOMAC score and WORMS cartilage morphology score(P＜0.01).Conclusion T1-ρ value,T2 value and T2*value measured by multiparametric magnetic resonance imaging combined with ADC have a certain suggestive role in the diagnosis of KOA,and are correlated with the severity of KOA.
刘胜菊;赵振英;耿玉洁;田会;刘娜;赵新蕊
石家庄市第二医院医学影像科,石家庄 050000石家庄市第二医院骨科,石家庄 050000石家庄市第二医院医学影像科,石家庄 050000石家庄市人民医院骨二科,石家庄 050031石家庄市第二医院医学影像科,石家庄 050000河北医科大学基础医学院,石家庄 050031
膝骨关节炎软骨磁共振成像麦克马斯特大学骨关节炎指数全器官磁共振成像系统受试者工作特征
knee osteoarthritiscartilagemagnetic resonance imagingWestern Ontario and Mcmaster Universities Osteothritis IndexWhole-Organ Magnetic Resonance Imaging Systemreceiver operating characteristic
《临床误诊误治》 2026 (12)
53-58,6
河北省医学科学研究课题计划项目(20251096)石家庄市科技计划自筹资金项目(2414608003)
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