髌下脂肪垫MRI信号与膝关节骨关节炎相关性的横断面研究

摘要

Objective:To investigate the correlation between MRI signal for infrapatellar fat pad (IPFP) and pathological changes in knee osteoarthritis (KOA),and to analyze the role of IPFP in the development of knee osteoarthritis.Methods:A total of 114 subjects (without special knee disease) were enrolled for this study.The intensity of MRI signal for IPFP was determined by fat-suppressed proton-density-weighted turbospin-echo magnetic resonance imaging.Based on the cartilage defects and osteophytes of knee joint,the subjects were divided into a KOA group and a control group.The difference of MRI signal for IPFP between two groups was analyzed.Results:After excluding the potential confounders of age,gender and BMI,the intensity of MRI signal for IPFP was positively correlated with defections in patellar,medial femur,lateral tibial or knee joint (OR 1.333 to 2.168,P 0.006 to 0.023);the intensity of MRI signal for IPFP was also positively correlated with osteophytes in patellar,medial femur,lateral tibial or knee joint (OR 1.309 tol.781,P 0.004 to 0.046);the intensity of MR/signal for IPFP in the KOA group was significantly higher than that in the control group (P=0.028).Conclusion:The increase in the density of MRI signal for IPFP is an imaging manifestation for knee degeneration.IPFP inflammation and endocrine abnormalities may play an important role in KOA.%目的:分析髌下脂肪垫(infrapatellar fat pad,IPFP) MRI信号强度与膝关节骨关节炎(keen osteoarthritis,KOA)病理改变的相关性,探讨IPFP在KOA中的作用.方法:对114位没有特殊膝关节疾病的体检职工(114膝)进行问卷调查,在MRI三维脂肪抑制质子密度加权快速自旋回波序列上测定IPFP信号强度,并对膝关节软骨缺损、骨赘进行评分,分析IPFP信号强度与软骨缺损、骨赘的相关性.进一步将受试者划分为KOA组和对照组,比较两组之间IPFP信号强度的差异.结果:Logistic回归分析结果显示:消除年龄、性别、BMI的混杂后,IPFP信号强度与髌骨、股骨内侧、胫骨外侧、全膝关节软骨缺损呈明显正相关(OR为1.333～2.168,P为0.006～0.023);与髌骨、股骨内侧、全膝关节骨赘呈明显正相关(OR为1.309～1.781,P为0.004～0.046).KOA组IPFP信号强度高于对照组,其差异有统计学意义(P=0.028).结论:IPFP MRI信号增高是膝关节退变的影像学表现之一;IPFP炎症和内分泌异常可能在KOA病变中发挥重要作用.