Abstract：
BACKGROUND: Bone marrow lesions (BMLs) in knee osteoarthritis (OA) have been assessed histopathologically and by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI); however, a direct comparison of the results has not been reported.
OBJECTIVE: To evaluate and compare the findings by DCE-MRI and histopathology of subchondral BMLs in knee OA.
METHODS: In total, 19 patients with medial tibiofemoral knee OA undergoing total knee arthroplasty were analyzed. Preoperative MRI, including a DCE sequence, was performed, and bone biopsies were obtained from the resected specimens corresponding to BML areas. The contrast enhancement by DCE-MRI was analyzed using semi-quantitative (area under the curve [AUC]), peak enhancement [PE]), and quantitative (Ktrans, Kep) methods. Enhancement in the medial OA compartment was compared with similar areas in a normal lateral compartment, and the DCE characteristics of BMLs were correlated with semi-quantitatively graded histopathological features.
RESULTS: AUC and PE were significantly higher in medial tibial and femoral BMLs compared with the values in the lateral condyles; Ktrans and Kep were only significantly higher in the tibial plateau. In the tibia, AUC and PE were significantly correlated with the grade of vascular proliferation, and PE also with the degree of marrow fibrosis. There was no significant correlation between AUC/PE and histopathological findings in the femur and no correlation between quantitative DCE parameters and histopathological findings.
CONCLUSIONS: BML characteristics by semi-quantitative DCE in the form of AUC and PE may be used as parameters for the degree of histopathological vascularization in the bone marrow whereas quantitative DCE data were less conclusive.
OBJECTIVE: To evaluate and compare the findings by DCE-MRI and histopathology of subchondral BMLs in knee OA.
METHODS: In total, 19 patients with medial tibiofemoral knee OA undergoing total knee arthroplasty were analyzed. Preoperative MRI, including a DCE sequence, was performed, and bone biopsies were obtained from the resected specimens corresponding to BML areas. The contrast enhancement by DCE-MRI was analyzed using semi-quantitative (area under the curve [AUC]), peak enhancement [PE]), and quantitative (Ktrans, Kep) methods. Enhancement in the medial OA compartment was compared with similar areas in a normal lateral compartment, and the DCE characteristics of BMLs were correlated with semi-quantitatively graded histopathological features.
RESULTS: AUC and PE were significantly higher in medial tibial and femoral BMLs compared with the values in the lateral condyles; Ktrans and Kep were only significantly higher in the tibial plateau. In the tibia, AUC and PE were significantly correlated with the grade of vascular proliferation, and PE also with the degree of marrow fibrosis. There was no significant correlation between AUC/PE and histopathological findings in the femur and no correlation between quantitative DCE parameters and histopathological findings.
CONCLUSIONS: BML characteristics by semi-quantitative DCE in the form of AUC and PE may be used as parameters for the degree of histopathological vascularization in the bone marrow whereas quantitative DCE data were less conclusive.
摘要：
背景：已经通过组织病理学和动态对比增强磁共振成像（DCE-MRI）评估了膝骨关节炎（OA）中的骨髓病变（BMLs）；然而，结果的直接比较尚未报道.
目的：评估和比较DCE-MRI和膝关节OA软骨下BMLs的组织病理学表现。
方法：总共，对19例内侧胫股膝关节OA行全膝关节置换术的患者进行分析。术前MRI,包括DCE序列，被执行，和骨活检是从对应于BML区域的切除标本中获得的。使用半定量分析（曲线下面积[AUC]）分析DCE-MRI的对比增强，峰值增强[PE])，和定量(Ktrans，Kep）方法。将内侧OA隔室的增强与正常外侧隔室的相似区域进行比较，BMLs的DCE特征与半定量分级的组织病理学特征相关。
结果：与外侧髁相比，胫骨内侧和股骨BMLs的AUC和PE明显较高；Ktrans和Kep仅在胫骨平台中明显较高。在胫骨，AUC和PE与血管增生程度显著相关,和PE也与骨髓纤维化程度有关。AUC/PE与股骨组织病理学发现之间没有显着相关性，定量DCE参数与组织病理学发现之间没有相关性。
结论：以AUC和PE形式的半定量DCE的BML特征可用作骨髓组织病理学血管化程度的参数，而定量DCE数据的结论性较低。
目的：评估和比较DCE-MRI和膝关节OA软骨下BMLs的组织病理学表现。
方法：总共，对19例内侧胫股膝关节OA行全膝关节置换术的患者进行分析。术前MRI,包括DCE序列，被执行，和骨活检是从对应于BML区域的切除标本中获得的。使用半定量分析（曲线下面积[AUC]）分析DCE-MRI的对比增强，峰值增强[PE])，和定量(Ktrans，Kep）方法。将内侧OA隔室的增强与正常外侧隔室的相似区域进行比较，BMLs的DCE特征与半定量分级的组织病理学特征相关。
结果：与外侧髁相比，胫骨内侧和股骨BMLs的AUC和PE明显较高；Ktrans和Kep仅在胫骨平台中明显较高。在胫骨，AUC和PE与血管增生程度显著相关,和PE也与骨髓纤维化程度有关。AUC/PE与股骨组织病理学发现之间没有显着相关性，定量DCE参数与组织病理学发现之间没有相关性。
结论：以AUC和PE形式的半定量DCE的BML特征可用作骨髓组织病理学血管化程度的参数，而定量DCE数据的结论性较低。
