Page 144 - 磁共振成像2024年7期电子刊

磁共振成像 2024年7月第15卷第7期 Chin J Magn Reson Imaging, Jul, 2024, Vol. 15, No. 7 临床研究｜｜Clinical Articles

髌下脂肪垫 IDEAL-IQ 和 T2 mapping 定量

参数与膝骨关节炎程度的相关性研究

1*
3
1
1, 2
1, 2
郝天琦 ，张园 ，王国华 ，黄小铭 ，杨雅晴 ，赵鸿飞 1
作者单位 1. 青岛市市立医院放射科，青岛 266011；2. 大连医科大学研究生院，大连 116000；3. 青岛市市立医院胸外科，青岛
266011
* 通信作者 王国华，E-mail: wangguohua89@163.com
中图分类号 R445.2；R684.3 文献标识码 A DOI 10.12015/issn.1674-8034.2024.07.023
本文引用格式 郝天琦, 张园, 王国华, 等. 髌下脂肪垫IDEAL-IQ和T2 mapping定量参数与膝骨关节炎程度的相关性研究[J]. 磁共
振成像, 2024, 15(7): 137-142.

[摘要] 目的 探讨膝骨关节炎（knee osteoarthritis, KOA）患者髌下脂肪垫（infrapatellar fat pad, IPFP）脂肪分数（fat fraction,
FF）及 T2 值与 KOA 程度之间的关系。材料与方法 前瞻性招募同日行膝关节 X 线和 MRI 检查的受检者（男 34 例，女 65 例），
依据膝关节 X 线 Kellgren-Lawrence 分级（KLG）将受检者分成无 KOA 组（KLG 0~1 级）、轻度 KOA 组（KLG 2 级）和重度
KOA 组（KLG 3~4 级）三组。应用 3.0 T MR 非对称回波的最小二乘估算法迭代水脂分离（iteraterative decomposition of water
and fat with echo asymmetry and least-squares estimation quantitation, IDEAL-IQ）、T2 mapping 技术测量 IPFP 的 FF 及 T2 值，采用
Pearson 或 Spearman 相关性分析 FF 值及 T2 值与 KOA 程度的相关性；采用受试者工作特征（receiver operating characteristic,
ROC）曲线评估其对 KOA的诊断性能。结果 随着 KOA程度进展，IPFP的 FF值相应越低，T2值越高。无 KOA、重度 KOA和
轻度 KOA 三组间 FF 及 T2 值差异显著，三组的 FF 值分别为 73.13%±3.98%，67.42%±2.25%，61.92%±3.24%，T2 值分别为
81.04 （79.61， 82.44） ms， 82.72 （81.44， 84.46） ms， 86.79 （85.32， 89.12） ms， 两 两 组 间 比 较 均 具 有 统 计 学 意 义
（P<0.001）。IPFP FF 值与 KLG 呈负相关（r=−0.779），T2 值与 KLG 之间呈正相关（r=0.688）。应用 FF 值及 T2 值诊断有无 KOA
的曲线下面积（area under the curve, AUC）分别为 0.937、0.837，敏感度分别为 71.8%、70.0%，特异度分别为 91.7%、82.1%。
结论 IPFP 的 FF 值及 T2 值与 KOA 严重程度相关，可以在一定程度上反映 IPFP 的病理生理改变，有望作为 KOA 新的评估
手段。
[关键词] 膝关节骨关节炎；髌下脂肪垫；磁共振成像；定量测量
Study on the correlation between infrapatellar fat pad IDEAL-IQ and T2 mapping sequences
and the severity of knee osteoarthritis

HAO Tianqi , ZHANG YUAN , WANG Guohua , HUANG Xiaoming , Yang Yaqing , ZHAO Hongfei 1
1*
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1 Department of Radiology, Qingdao Municipal Hospital, Qingdao 266011, China; Graduate School, Dalian Medical University, Dalian
2
3
116000, China; Department of Thoracic Surgery, Qingdao Municipal Hospital, Qingdao 266011, China
* Correspondence to WANG G H, E-mail: wangguohua89@163.com
Received 20 Feb 2024, Accepted 9 Jul 2024; DOI 10.12015/issn.1674-8034.2024.07.023
Cite this article as HAO T Q, ZHANG Y, WANG G H, et al. Study on the correlation between infrapatellar fat pad IDEAL-IQ and T2
mapping sequences and the severity of knee osteoarthritis[J]. Chin J Magn Reson Imaging, 2024, 15(7): 137-142.
Abstract Objective: To investigate the relationship between the fat fraction (FF) and T2 values of the infrapatellar fat pad (IPFP) and
the severity of knee osteoarthritis (KOA) in patients. Materials and Methods: Prospective recruitment included 99 participants (34
males, 65 females) who underwent knee joint X-ray and MRI on the same day. Participants were categorized into three groups based on
knee joint X-ray Kellgren-Lawrence grading (KLG): no KOA group (KLG 0-1), mild KOA group (KLG 2), and severe KOA group (KLG
3-4). The FF and T2 values of the IPFP were measured using 3.0 T MR iteraterative decomposition of water and fat with echo asymmetry
and least-squares estimation quantitation (IDEAL-IQ) and T2 mapping techniques, and employed Pearson or Spearman correlation
analysis to examine the relationship between FF values, T2 values, and the severity of KOA. The diagnostic performance of FF and T2
values for KOA was evaluated using receiver operating characteristic (ROC) curves. Results: As the severity of KOA progressed, the FF
of the IPFP decreased correspondingly, and the T2 values increased. There were significant differences in FF and T2 values among the no
KOA, severe KOA, and mild KOA groups, with FF values of 73.13%±3.98%, 67.42%±2.25%, and 61.92%±3.24%, and T2 values of
81.04 (79.61, 82.44) ms, 82.72 (81.44, 84.46) ms, and 86.79 (85.32, 89.12) ms, respectively (all P<0.001). The FF values were negatively
correlated with KLG (r=−0.779), while the T2 values were positively correlated with KLG (r=0.688). The area under the curve (AUC)
for diagnosing the presence of KOA using FF and T2 values was 0.937 and 0.837, with sensitivities of 71.8% and 70.0%, and
specificities of 91.7% and 82.1%, respectively. Conclusions: Changes in FF and T2 values of the IPFP can to some extent reflect the
pathophysiological changes of the IPFP and are related to the severity of KOA, providing new methods for the evaluation of KOA.
Key words knee osteoarthritis; infrapatellar fat pad; magnetic resonance imaging; quantitative detection

0 引言 1990 年至 2019 年间，KOA 的患病人数增加约 48%，
膝骨关节炎（knee osteoarthritis, KOA）主要以软 最终致残率高达 53% [3-4] 。由于其病因尚未明确，致
骨破坏、滑膜炎症和骨质增生等表现为特征，是老年 病因素多种多样，发展到终末期往往需要手术治疗，
[5]
人 最 常 见 的 退 行 性 关 节 疾 病 之 一 [1-2] ，研 究 显 示 当前仍无有效方法治愈或逆转 KOA 的病理过程 ，

收稿日期 2024-02-20 接受日期 2024-07-09

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