Quantitative evaluation in combination with nonquantitative evaluation in early patellar cartilage osteoarthritis at 3.0 T
Houdong Zuo,1 Weiwu Yao,1 Nan Qu,1 Shixun Yang,1 Jianhua Wang,2 Xiaojiang Cui3
1Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China; 2Department of Orthopedics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 3Department of Surgery, Department of Obstetrics and Gynecology, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Purpose: To evaluate quantitative T1 and T2 relaxation times and magnetization transfer ratios (MTRs) in the early diagnosis of patellar cartilage osteoarthritis (OA) and to quantify and possibly refine the current Kellgren-Lawrence score criteria.
Materials and methods: A total of 92 cases of knee joints with 40 normal volunteers and 30 patients with OA were prospectively evaluated. The knee joints with OA were divided into mild and moderate groups according to the Kellgren-Lawrence score criteria. The discriminative analysis method was used to analyze the accuracy of the original grouped cases correctly classified by age, sex, T1 relaxation times, T2 relaxation times, and MTR values. Linear regression analysis was used between T1 relaxation time, T2 relaxation time, and MTR values.
Results: The mean T1 relaxation times decreased with the severity of OA, and a significant difference was only found between the normal and moderate OA groups (P<0.05). The mean T2 relaxation times increased, and significant differences were found between the normal and mild OA groups and the normal and moderate OA groups (P<0.001). The MTR values were 35.8%±4.2%, 36.1%±3.2%, and 35.4%±3.8%, respectively. There were no significant differences between the normal and OA groups. In addition, T1 relaxation times were positively correlated with MTR values (P<0.01). A discriminative analysis using a synthesis of all the influential factors indicated a high accuracy rate (93.9%) for the correct classification of the original grouped cases.
Conclusion: Quantitative T1 and T2 relaxation times were useful in the diagnosis of early OA; T2 relaxation times were more relatively sensitive. The functional usefulness of MTR values may be limited. T1 relaxation times positively correlated with MTR values. Multiple quantitative parameters, combined with some relative nonquantitative clinical parameters and Kellgren-Lawrence scores, may be useful in the early stage of OA and provide better information for clinical treatment and follow-up.
Keywords: osteoarthritis, patellar cartilage, magnetic resonance imaging, T1 relaxation time, T2 relaxation time, MTR, age, sex
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