摘要
目的:探讨股四头肌脂肪垫(QFP)和股前脂肪垫(PFP)的形态和信号特征与膝关节放射学骨性关节炎(ROA)结构改变的关系。方法:回顾性分析纳入的60个临床资料齐全的膝关节X线和MRI检查图像资料,于矢状面PDW-SPAIR序列图像上定量测量QFP最大前后径、最大头尾径、最大斜径和最大面积及PFP的最大厚度。半定量评估QFP高信号、占位效应及PFP髌股间脂肪高信号。采用独立样本t检验和Spearman相关系数分析QFP和PFP形态和信号改变与膝关节放射学骨性关节炎KLG分级(Kellgren-Lawrence Grading)、Hoffa滑膜炎、渗出性滑膜炎、软骨缺损及软骨下骨髓病变的相关性。结果:QFP的头尾径、高信号、占位效应、PFP髌股间高信号和PFP最大厚度在ROA组和非ROA组中存在统计学差异(P<0.05)。QFP高信号,PFP髌股高信号,PFP最大厚度与K-L分级呈轻度到中度相关(r分别为0.260,0.397,-0.423,P<0.05)。QFP高信号,QFP占位效应,PFP最大厚度与Hoffa滑膜炎存在轻度到中度相关(r分别为0.328,-0.285,-0.436,P<0.05)。PFP最大厚度与渗出性滑膜炎呈中度负相关(r=-0.557,P<0.05)。PFP髌股间脂肪高信号与不同亚区软骨缺损呈不同程度的正相关(r为0.286~0.406,P<0.05),QFP占位效应及PFP最大厚度则与不同亚区软骨缺损呈不同程度的负相关(r为-0.291~0.500,P<0.05)。QFP前后径与胫骨内侧软骨缺损呈轻度负相关(r为-0.259,P<0.05)。QFP前后径、PFP髌股高信号与胫骨内侧,胫骨外侧软骨下骨髓病变呈轻度到中度相关(r分别为-0.273和-0.277,0.408和0.281,P<0.05),PFP最大厚度与胫骨内侧软骨下骨髓病变呈轻度相关(r=-0.305,P<0.05)。结论:股四头肌脂肪垫和股前脂肪垫的形态和信号特征与膝关节放射学骨性关节炎(KLG分级)和MR滑膜炎改变、软骨缺损及软骨下骨髓病变均存在一定的相关性,可能是膝关节骨性关节炎发展的潜在影响因素。
Objective:To describe the associations between the morphology and signal characteristics of quadriceps fat pad(QFP)and prefemorl fat pad(PFP)and the structural changes of radiographic osteoarthritis(ROA)of the knee.Methods:A total of 60 knee of X-ray and MRI images with complete clinical data were retrospectively analyzed.The maximum anteroposterior diameter,maximum craniocaudal diameter,maximum oblique diameter and maximum area of QFP,and the maximum thickness of PFP were measured on sagittal PDW-SPRIR sequence images.Hypersignal of QFP,mass effect and PFP patellofemoral hyperintensity alteration were evaluated semi-quantitatively.The independent sample t test and Spearman correlation coefficient were used to analyze the correlation between QFP and PFP morphology and signal changes and Kellgren-Lawrence grading(KLG),Hoffa synovitis,effusion synovitis,cartilage defect and subchondral bone marrow lesions of knee radiological osteoarthritis.Results:There were significant differences in craniocaudal diameter of QFP,high signal,mass effect,PFP patellofemoral hyperintensity alteration and PFP maximum thickness between ROA group and non-ROA group(P<0.05).QFP high signal,PFP patellofemoral high signal,PFP maximum thickness was mildly to moderately correlated with KLG(R=0.260,0.397,-0.423,P<0.05).High QFP signal,QFP placeholder effect,and the maximum thickness of PFP were mildly to moderately correlated with Hoffa's synovitis(R=0.328,-0.285,-0.436,P<0.05).There was a moderate negative correlation between PFP maximum thickness and exudative synovitis(r=-0.557,P<0.05).The PFP interpatellofemoral fat hypersignal was positively correlated with the cartilage defect in different subregions(R 0.286~0.406,P<0.05),while the QFP mass effect and the maximum thickness of PFP were negatively correlated with the cartilage defect in different subregions(R-0.291~0.500,P<0.05).There was a slight negative correlation between the anteroposterior diameter of QFP and medial tibial cartilage defect(r=-0.259,P<0.05).QFP anteroposterior diamete
作者
李勉文
张晓东
张鑫涛
钟丽洁
陈焱君
LI Mian-wen;ZHANG Xiao-dong;ZHANG Xin-tao(Department of Medical Imaging,the Third Affiliated Hospital of Southern Medical University(Academy of Orthopedics·Guangdong Province),Guangzhou,510630,China)
出处
《放射学实践》
CSCD
北大核心
2022年第2期236-242,共7页
Radiologic Practice
基金
国家自然青年基金(81801653)。
关键词
骨关节炎
四头肌
脂肪组织
磁共振成像
Osteoarthritis
Quadriceps muscle
Adipose tissue
Magnetic resonance imaging
