Osteoarthritis imaging最新文献_第2页

The 18th international workshop on osteoarthritis imaging. Structure and pain: Where are we today? 第18届国际骨关节炎影像研讨会。结构和痛苦：我们今天在哪里？

Osteoarthritis imaging

Pub Date : 2025-09-01 DOI: 10.1016/j.ostima.2025.100356

Hamid Harandi , Soheil Mohammadi , Ali Guermazi

Objective

This paper provides a comprehensive overview of the key themes, new findings, and research directions highlighted during the keynote presentations and panel discussions at the IWOAI 2024.

Design

Comprehensive literature review of keynote lectures and submitted scientific abstracts presented during the 18th IWOAI held in Marrakesh, Morocco.

Results

The 18th International Workshop on Osteoarthritis Imaging (IWOAI) was held from June 25 to June 28, 2024, in Marrakesh, Morocco. The main theme of the workshop was Structure and Pain: Where Are We Today? Ten sessions covering various aspects of new concepts and strategies related to structure and pain in the imaging of osteoarthritis (OA) were held. These sessions included nine keynote presentations and oral presentations of abstracts, addressing different topics such as structural factors in OA, pain management challenges in OA-related trials, and imaging outcomes as endpoints in these trials. The final session was a round table featuring participants from diverse scientific and clinical fields who discussed their perspectives on the utility of imaging in OA.

Conclusion

The meeting successfully informed the radiology community about current advances, research, and future directions in osteoarthritis-related structure and pain through keynote speeches and oral presentations.

目的对IWOAI 2024的主题演讲和小组讨论中突出的关键主题、新发现和研究方向进行全面概述。设计对在摩洛哥马拉喀什举行的第18届IWOAI会议上的主题演讲和提交的科学摘要进行综合文献综述。第18届国际骨关节炎影像学研讨会（IWOAI）于2024年6月25日至28日在摩洛哥马拉喀什举行。研讨会的主题是“结构与痛苦：我们今天在哪里？”十场会议涵盖了与骨关节炎（OA）成像中结构和疼痛相关的新概念和新策略的各个方面。这些会议包括9个主题演讲和摘要口头演讲，讨论不同的主题，如OA的结构因素，OA相关试验中的疼痛管理挑战，以及作为这些试验终点的成像结果。最后的会议是一个圆桌会议，来自不同科学和临床领域的参与者讨论了他们对OA成像应用的看法。通过主题演讲和口头报告，会议成功地向放射学界介绍了骨关节炎相关结构和疼痛的最新进展、研究和未来方向。

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引用次数: 0

Quantitative meniscus imaging and analysis: A narrative review 定量半月板成像和分析：叙述回顾

Osteoarthritis imaging

Pub Date : 2025-09-01 DOI: 10.1016/j.ostima.2025.100358

Kalpana Sharma

Objective

In this review, we summarize the literature on the evolution of magnetic resonance imaging (MRI), segmentation, and quantitative analysis (qMRI) of the meniscus, while bearing in mind the pivotal role of the meniscus in the development (incidence) and progression of symptomatic and structural knee osteoarthritis (KOA).

Design

We performed a literature search across PubMed and Google Scholar, spanning 35 years (1989–2024). We utilized keywords such as “meniscus”, “fibrocartilage”, “imaging”, “magnetic resonance”, “radiography”, “morphometry”, “quantitative analysis”, “knee”, “osteoarthritis”, “symptoms”, “pain”, “structure”, “progression”, “radiographic”, and “reproducibility”

Results

Technological advances in image acquisition, segmentation, and derivation of quantitative analytic endpoints pertinent to meniscus morphometry (e.g., height, width, and volume) and position (e.g., tibial coverage, extrusion area, and distance) within the joint are highlighted in the literature. Three-dimensional qMRI of the meniscus has emerged as a reliable and reproducible non-invasive measurement technology, offering enhanced efficacy for assessing the relationship of the meniscus with radiographic joint space width (JSW), knee pain, structural (radiographic) KOA status, and with symptomatic and structural progression of KOA. Quantitative measures of meniscal extrusion were found to be robust predictors of various imaging endpoints, including osteophyte formation, subchondral bone changes, cartilage loss, as well as significant clinical outcomes.

Conclusions

The emergence of quantitative meniscus measurement technology has revamped the field of meniscal imaging research, providing accurate 3D analysis of both morphometric and positional measures. The systematic application of this methodology has unveiled significant insights into a better understanding of the incidence and symptomatic and structural progression of KOA.

目的在本文中，我们总结了半月板的磁共振成像（MRI）、分割和定量分析（qMRI）的发展，同时考虑到半月板在症状性和结构性膝骨关节炎（KOA）的发生和进展中的关键作用。我们对PubMed和b谷歌Scholar进行了35年（1989-2024）的文献检索。我们使用了诸如“半月板”、“纤维软骨”、“成像”、“磁共振”、“放射学”、“形态测量学”、“定量分析”、“膝关节”、“骨关节炎”、“症状”、“疼痛”、“结构”、“进展”、“放射学”和“可重复性”等关键词。结果在图像采集、分割和推导与半月板形态测量（如高度、宽度和体积）和位置（如胫骨覆盖、挤压面积）相关的定量分析端点方面的技术进步。和关节内的距离)在文献中突出显示。半月板三维qMRI已成为一种可靠且可重复的无创测量技术，为评估半月板与x线关节间隙宽度（JSW）、膝关节疼痛、结构（x线）KOA状态以及KOA的症状和结构进展之间的关系提供了增强的有效性。半月板挤压的定量测量被发现是各种成像终点的可靠预测指标，包括骨赘形成、软骨下骨变化、软骨损失以及重要的临床结果。结论半月板定量测量技术的出现改变了半月板成像研究领域，提供了精确的三维形态测量和位置测量分析。该方法的系统应用为更好地理解KOA的发生率、症状和结构进展提供了重要见解。

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引用次数: 0

Erratum regarding missing Editor Disclosure statements in previously published articles 关于先前发表的文章中缺少编辑披露声明的勘误

Osteoarthritis imaging

Pub Date : 2025-09-01 DOI: 10.1016/j.ostima.2025.100372

引用次数: 0

Capturing deep partial-thickness cartilage loss with semiquantitative scoring: A supplemented MRI Osteoarthritis Knee Score (sMOAKS) 半定量评分捕捉深层部分厚度软骨损失：补充MRI骨关节炎膝关节评分（sMOAKS）。

Osteoarthritis imaging

Pub Date : 2025-09-01 DOI: 10.1016/j.ostima.2025.100272

Faysal Altahawi , Richard Lartey , Nancy Obuchowski , Xiaojuan Li , Carl S. Winalski

Objective

We propose a supplement to MOAKS (MRI Osteoarthritis Knee Score) for capturing >50 % partial thickness cartilage loss on knee MRI and measure reader agreement.

Design

MOAKS scores 2 severity levels of cartilage damage (any loss, full-thickness loss) within knee subregions with lesional area graded 0–3. We propose supplemented MOAKS (sMOAKS) by adding a similarly graded third level assessment for deep cartilage loss (DCL), >50 % thickness, in addition to traditional MOAKS for improved granularity of partial thickness cartilage loss. Using sMOAKS, two radiologists independently graded cartilage subscores for 40 knees and rescored 20 knees. Consolidated inter-reader and intra-reader agreement was calculated with kappa values for the DCL level supplement. To measure agreement for one example of a more granular combined sMOAKS outcome, coverage probability reader agreement was calculated for a scaled cartilage damage score (CDS), a summed normalized score (0–100) with equal weighting to articular surfaces combining subregion scores.

Results

DCL represented 27.8 % (63/227) of partial but not full-thickness cartilage loss subregion interpretations. Pooled subregion DCL involving >10 % surface area demonstrated 97.7 % (ĸ = 0.71) inter-reader agreement and 98.8 % (ĸ = 0.78) intra-reader agreement. For greatest subregion DCL size, weighted ĸ agreement was 0.73/0.82 (inter-reader/intra-reader) for articular surfaces and 0.75/0.83 for joint compartments. At 90 % CDS intra-reader agreement coverage, inter-reader CDS agreement values were 83 %, 82 %, and 78 % for surfaces, compartments, and whole joints, respectively.

Conclusions

There is substantial agreement for deep cartilage loss detection using sMOAKS across varied analysis methods. Further assessment will determine when the added granularity of sMOAKS is beneficial.

目的：我们建议对MOAKS （MRI骨关节炎膝关节评分）进行补充，用于在膝关节MRI上捕获bbb50 %的部分软骨厚度损失，并测量读者的同意度。设计：MOAKS评分膝关节亚区软骨损伤的严重程度为2级（任何损失，全层损失），病变面积为0-3级。我们建议对MOAKS （sMOAKS）进行补充，在传统MOAKS的基础上，对深度软骨损失（DCL）进行类似分级的第三级评估，厚度为50%，以改善部分厚度软骨损失的粒度。使用sMOAKS，两名放射科医生对40个膝关节的软骨进行了独立评分，并对20个膝关节进行了恢复。用kappa值计算DCL水平补充的综合读者间和读者内协议。为了衡量一个更颗粒化的sMOAKS结果的一致性，计算了一个分级软骨损伤评分（CDS）的覆盖概率读者一致性，这是一个与关节表面结合子区域评分同等权重的标准化评分（0-100）。结果：DCL占部分而非全层软骨丢失亚区解释的27.8%（63/227）。涉及bbb10 %表面积的合并子区域DCL显示97.7% （ =0.71）阅读器间一致性和98.8% （ =0.78）阅读器内一致性。对于最大的子区域DCL大小，关节面加权一致度为0.73/0.82（阅读器间/阅读器内），关节室加权一致度为0.75/0.83。在90%的CDS读卡器内一致性覆盖率下，表面、隔间和整个关节的读卡器间CDS一致性值分别为83%、82%和78%。结论：在不同的分析方法中，使用sMOAKS检测深层软骨损失有很大的一致性。进一步的评估将决定何时增加sMOAKS粒度是有益的。

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引用次数: 0

Genicular artery embolization and nerve ablation: Interventional radiology solutions for osteoarthritis related knee pain 膝动脉栓塞和神经消融：骨关节炎相关膝关节疼痛的介入放射学解决方案

Osteoarthritis imaging

Pub Date : 2025-06-01 DOI: 10.1016/j.ostima.2025.100271

Sheikh Muhammad Usman Shami , Nobuhiko Hata , Yan Epelboym

Objective

Osteoarthritis (OA) is a major cause of chronic knee pain, with treatment options ranging from conservative therapies to total knee replacement. Minimally invasive, image-guided interventions such as genicular artery embolization (GAE) and genicular nerve ablation (GNA) have emerged as alternatives for patients with refractory OA-related pain. This review explores these techniques and the role of interventional radiologists in multidisciplinary OA management.

Design

This narrative review synthesizes current evidence on the safety, efficacy, and technical aspects of GAE and GNA. GAE selectively embolizes genicular arteries supplying the knee joint and synovium, reducing synovitis by targeting abnormal neovascularity and hyperemia. The procedure is performed under fluoroscopic guidance and clinical studies have reported significant improvements in pain. GNA can be performed with ultrasound or fluoroscopic guidance. This technique utilizes radiofrequency ablation (RFA) to denervate sensory nerves thereby alleviating knee pain. Conventional, pulsed, and cooled RFA techniques are available and have demonstrated neuro-ablative effects.

Results

GAE and GNA have demonstrated high technical and clinical success, with significant reductions in Visual Analog Scale (VAS) pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and other patient reported outcome measures. Pain relief usually lasts from 6 to 12 months, with GAE benefits reported up to 24 months. Both procedures exhibit favorable safety profiles, with mostly mild, self-limiting adverse events.

Conclusion

GAE and GNA are effective minimally invasive options for patients who are not candidates for or unwilling to undergo knee replacement. Further randomized placebo-controlled trials are needed to confirm long-term efficacy for these interventions.

目的骨关节炎（OA）是慢性膝关节疼痛的主要原因，治疗选择从保守治疗到全膝关节置换术。微创，图像引导的干预措施，如膝动脉栓塞（GAE）和膝神经消融（GNA）已成为难治性oa相关疼痛患者的替代方案。这篇综述探讨了这些技术以及介入放射科医师在多学科OA管理中的作用。本综述综合了GAE和GNA的安全性、有效性和技术方面的现有证据。GAE选择性地栓塞供应膝关节和滑膜的膝动脉，通过靶向异常的新生血管和充血来减轻滑膜炎。该手术是在透视指导下进行的，临床研究报告了疼痛的显着改善。GNA可在超声或透视引导下进行。该技术利用射频消融术（RFA）去神经感觉神经，从而减轻膝关节疼痛。传统的、脉冲的和冷却的射频消融技术是可用的，并且已经证明了神经消融的效果。结果gae和GNA在技术和临床方面取得了很高的成功，显著降低了视觉模拟量表（VAS）疼痛、西安大略省和麦克马斯特大学骨关节炎指数（WOMAC）以及其他患者报告的结果测量。疼痛缓解通常持续6至12个月，据报道GAE的益处可达24个月。这两种方法都表现出良好的安全性，大多是轻微的、自限性的不良事件。结论对于不适合或不愿接受膝关节置换术的患者，ae和GNA是一种有效的微创选择。需要进一步的随机安慰剂对照试验来证实这些干预措施的长期疗效。

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引用次数: 0

Imaging of cartilage, meniscus, and beyond: Role of Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) 软骨、半月板及其他部位的成像：磁共振成像（MRI）和计算机断层扫描（CT）的作用

Osteoarthritis imaging

Pub Date : 2025-06-01 DOI: 10.1016/j.ostima.2025.100268

Patrick Omoumi

Magnetic Resonance Imaging (MRI) remains the reference standard for imaging cartilage and meniscus, offering superior soft tissue contrast essential for comprehensive joint assessment in osteoarthritis (OA). However, recent technological advancements in Computed Tomography (CT)—spectral imaging, and weight-bearing scanners—have sparked renewed interest in utilizing CT, and CT arthrography in the evaluation of OA. This narrative mini-review explores the strengths and limitations of both MRI and CT in imaging cartilage and meniscus, and presents some trends in the research setting.

MRI remains the modality of choice for joint imaging, offering excellent soft tissue contrast and comprehensive articular assessment. CT is the reference for the assessment of mineralized tissue imaging, and in association with arthrography (CT arthrography, CTA), provides high performance in the diagnosis of surface lesions.

In the research setting, efforts have focused on the acceleration of MRI acquisitions, with deep learning reconstructions disrupting the traditional trade-off between acquisition speed and image quality. Efforts are undertaken to standardize compositional MRI techniques, which probe early-stage biochemical tissular changes. Emerging techniques such as synthetic imaging may offer the ability to provide information on bone and soft tissues in a single acquisition. Weight-bearing acquisitions have allowed the assessment of joint structures, in particular menisci, in a loaded position. Photon-counting CT promises higher resolution, improved material separation without increasing radiation exposure. Finally, post-processing tools are being developed to leverage large quantities of data and integrate both modalities in a complementary framework that could provide a robust toolset for the assessment of OA.

磁共振成像（MRI）仍然是软骨和半月板成像的参考标准，为骨关节炎（OA）的综合关节评估提供了优越的软组织对比。然而，最近计算机断层扫描（CT）的技术进步——光谱成像和负重扫描仪——重新激发了人们对利用CT和CT关节造影评估OA的兴趣。这篇叙述性的综述探讨了MRI和CT在软骨和半月板成像方面的优势和局限性，并提出了一些研究方向。MRI仍然是关节成像的首选方式，提供出色的软组织对比和全面的关节评估。CT是评估矿化组织成像的参考，并与关节摄影（CT关节摄影，CTA）相结合，在诊断表面病变方面提供了高性能。在研究环境中，努力的重点是加速MRI采集，深度学习重建打破了传统的采集速度和图像质量之间的权衡。努力进行标准化组成MRI技术，探测早期生化组织的变化。新兴技术，如合成成像，可以在一次采集中提供有关骨骼和软组织的信息。负重检查可以评估关节结构，特别是处于负荷位置的半月板。光子计数CT有望在不增加辐射暴露的情况下提高分辨率，改善材料分离。最后，正在开发后处理工具，以利用大量数据并将这两种模式整合到一个互补框架中，从而为评估OA提供一个强大的工具集。

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引用次数: 0

Imaging of osteoarthritis-related bone marrow lesions in clinical trials 临床试验中骨关节炎相关骨髓病变的影像学研究

Osteoarthritis imaging

Pub Date : 2025-06-01 DOI: 10.1016/j.ostima.2025.100270

Kamyar Moradi , Olga Kubassova , John A. Carrino

Objective

This narrative review aims to summarize current evidence regarding the imaging detection of bone marrow lesions (BMLs), their prognostic value for osteoarthritis (OA) progression and pain, as well as potential therapeutic interventions targeting BMLs in OA clinical trials.

Design

We performed a literature search in PubMed and Google Scholar for articles focusing on OA-related BMLs. Studies were included if they examined detection, pathophysiology, clinical significance, or treatments of knee BMLs. Non-OA etiologies (e.g., malignancy, rheumatologic diseases) were excluded.

Results

BMLs, present in approximately two-thirds of patients with knee OA, are considered key indicators of subchondral bone damage or microfracture. MRI is highly sensitive for detecting BMLs, using validated semi-quantitative and quantitative measurement methods. The lack of disease-modifying OA drugs has shifted interest toward targeting BMLs for potential therapeutic interventions. Clinical studies have shown that changes in BML volume can predict the subsequent incidence of OA in joints without established disease, and that their presence is associated with pain progression and structural deterioration when OA is already established. Potential treatments for OA-related BMLs include pharmacological agents that modify subchondral bone turnover, anti-inflammatory interventions, biomechanical stress reduction techniques, cellular therapies, dietary modifications, and surgical approaches.

Conclusions

A holistic and personalized approach is essential for advancing OA management and improving patient outcomes by effectively targeting BMLs. Incorporating patient-reported outcomes and quality-of-life measures, as well as considering combined treatment strategies, will strengthen future trials aimed at modifying BMLs.

目的本综述旨在总结目前关于骨髓病变（BMLs）影像学检测的证据，它们对骨关节炎（OA）进展和疼痛的预后价值，以及OA临床试验中针对BMLs的潜在治疗干预措施。我们在PubMed和b谷歌Scholar中进行了文献检索，以查找与oa相关的bml的文章。如果研究检测、病理生理学、临床意义或膝关节BMLs的治疗，则纳入研究。排除非oa病因（如恶性肿瘤、风湿病）。结果：大约三分之二的膝关节OA患者存在bmls， bmls被认为是软骨下骨损伤或微骨折的关键指标。MRI对bml的检测具有高度敏感性，采用了经过验证的半定量和定量测量方法。由于缺乏改善疾病的OA药物，人们的兴趣转向了靶向bml作为潜在的治疗干预措施。临床研究表明，BML体积的变化可以预测无疾病关节的后续OA发病率，并且当OA已经建立时，BML体积的存在与疼痛进展和结构恶化有关。oa相关BMLs的潜在治疗方法包括改变软骨下骨转换的药理学药物、抗炎干预、生物力学减压技术、细胞疗法、饮食调整和手术方法。结论全面、个性化的治疗方法是提高OA管理水平和改善患者预后的关键。结合患者报告的结果和生活质量测量，以及考虑联合治疗策略，将加强旨在修改bml的未来试验。

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引用次数: 0

Microstructural imaging of the cartilaginous endplate in the intervertebral disc 椎间盘软骨终板的显微结构成像

Osteoarthritis imaging

Pub Date : 2025-06-01 DOI: 10.1016/j.ostima.2025.100269

Valtteri Peitso , Shuvashis Das Gupta , Ali Mobasheri

(1) Objective

Intervertebral disc (IVD) degeneration is a major risk factor for the development of chronic low back pain (LBP), affecting millions globally, particularly as they age. IVD degeneration can promote inflammation, and reduce spinal stability leading to compression of nerve roots. Research has primarily focused on the annulus fibrosus (AF) or nucleus pulposus (NP), with an unmet need to explore the physiology of the cartilaginous endplate (CEP) and its microstructural assessment in IVD degeneration. Imaging the microstructure of the CEP, a relatively thin layer between the IVD and vertebral body, is challenging. This mini-review discusses advanced imaging methods to capture the microstructure of the CEP.

(2) Design

This narrative mini-review explores current methods for in vitro and ex vivo microstructural imaging of the CEP using advanced techniques such as three-dimensional (3D) micro-computed tomography (µCT) and two-dimensional (2D) light microscopy.

(3) Results

Advanced imaging techniques can provide detailed visualization of IVD microarchitecture, structural integrity, and degeneration, including CEP structure. Optical light microscopy techniques provide detailed 2D images of the CEP from stained or unstained IVD sections. Imaging the IVD in a 3D modality, such as contrast-enhanced µCT, enables a better understanding of the CEP’s microstructural changes in IVD degeneration.

(4) Conclusions

High-resolution 3D imaging of the CEP could be useful for visualizing and quantifying the response of degenerated tissue to experimental therapeutics ex vivo. Moreover, analyzing CEP-driven microstructural degeneration is crucial for developing preclinical anatomical models that spine surgeons can use to test and evaluate medical and therapeutic candidates.

(1)目的椎间盘退变（IVD）是慢性腰痛（LBP）发展的主要危险因素，影响全球数百万人，尤其是随着年龄的增长。IVD变性可促进炎症，降低脊柱稳定性，导致神经根受压。研究主要集中在纤维环（AF）或髓核（NP）上，对IVD退变中软骨终板（CEP）的生理学及其显微结构评估的探索尚未得到满足。CEP是IVD和椎体之间相对较薄的一层，其显微结构成像具有挑战性。(2)设计：本文探讨了目前使用三维（3D）微型计算机断层扫描（µCT）和二维（2D）光学显微镜等先进技术进行体外和离体CEP显微结构成像的方法。(3)结果：先进的成像技术可以提供IVD微结构、结构完整性和退变的详细可视化。包括CEP结构。光学光学显微镜技术可从染色或未染色的IVD切片中提供详细的CEP二维图像。对IVD进行三维成像，如增强对比的微CT，可以更好地了解IVD退行性变时CEP的微观结构变化。(4)结论高分辨率CEP三维成像可用于可视化和量化退行性组织对体外实验治疗的反应。此外，分析cep驱动的微观结构退化对于开发临床前解剖模型至关重要，脊柱外科医生可以使用该模型来测试和评估医学和治疗候选人。

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引用次数: 0

Methods of measuring radiographic patellofemoral joint alignment and morphology: A scoping review 髌骨股骨关节线向和形态的x线测量方法：范围检查综述

Osteoarthritis imaging

Pub Date : 2025-06-01 DOI: 10.1016/j.ostima.2025.100262

Jonathan R. Hill , Edwin H.G. Oei , Kay M. Crossley , Hylton B. Menz , Erin M. Macri , Michelle D. Smith , Narelle Wyndow , Liam R. Maclachlan , Megan H. Ross , Natalie J. Collins

Objective

Conduct a scoping review to identify radiographic measures of patellofemoral joint (PFJ) alignment and bony morphology reported in literature published during a representative period (2014–2018), and describe their reported measurement properties.

Design

Eight electronic databases were searched using keywords relating to “patellofemoral” and “radiograph”. Identified records were screened for eligibility by two independent assessors. English-language studies published in the years 2014–2018 were included if they reported: (i) acquiring PFJ radiographs; (ii) method of radiograph acquisition; and (iii) descriptions of radiographic PFJ alignment and bony morphology measures. Non-human and cadaveric studies, single-case studies, and studies with mean participant age <10 years were excluded. For studies that reported measurement properties (reliability, validity, responsiveness), quality appraisal was performed by two independent assessors using the COSMIN Risk of Bias tool. Descriptive data were reported.

Results

Of 18,678 records identified, 336 articles met our criteria . Ninety-one unique radiographic alignment and morphology measures were described. Most prevalent were measures of patellar height (222, 66.1 %), patellar alignment (142, 42.3 %), and patellar inclination (121, 36 %). Reliability data were reported by 83 (24.7 %) of the studies.

Conclusions

During the selected period, 91 different radiographic measures of PFJ alignment and morphology were reported, with multiple methods used to obtain similar measures, and limited data on reliability and validity. These findings make it difficult to recommend specific measures for clinical and research use. Further studies are needed to determine the measurement properties of radiographic PFJ alignment and morphology measures, and to establish consensus-based recommendations for priority measures and acquisition methods for specific PFJ conditions.

目的对代表性时期（2014-2018年）发表的文献中报道的髌骨股关节（PFJ）对准和骨形态的放射测量方法进行范围综述，并描述其报道的测量特性。使用与“髌骨”和“x线照片”相关的关键词搜索designight电子数据库。确定的记录由两名独立评估员筛选是否合格。2014-2018年发表的英语研究，如果它们报告：(i)获得PFJ x光片；（二）x光片采集方法；（iii） PFJ的x线对准和骨形态测量的描述。排除了非人类和尸体研究、单病例研究和参与者平均年龄为10岁的研究。对于报告了测量特性（信度、效度、响应性）的研究，质量评估由两名独立评估人员使用COSMIN偏倚风险工具进行。报告描述性数据。结果在18,678篇文献中，336篇符合我们的标准。描述了91种独特的射线照相对准和形态学措施。最常见的是测量髌骨高度（222,66.1%），髌骨对齐（142,42.3%）和髌骨倾角（121,36%）。83项（24.7%）研究报告了可靠性数据。在选定的时间内，报告了91种不同的PFJ对齐和形态的放射学测量方法，使用了多种方法获得相似的测量方法，并且可靠性和有效性数据有限。这些发现使得很难推荐临床和研究使用的具体措施。需要进一步的研究来确定放射照相PFJ对准和形态学测量的测量特性，并为特定PFJ条件下的优先测量和获取方法建立基于共识的建议。

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引用次数: 0

Radiomic features of infrapatellar fat pad are associated with knee symptoms and radiographic post-traumatic osteoarthritis at 10+ years after anterior cruciate ligament reconstruction 髌下脂肪垫的放射学特征与前交叉韧带重建后10年以上创伤后骨关节炎的膝关节症状和影像学相关

Osteoarthritis imaging

Pub Date : 2025-06-01 DOI: 10.1016/j.ostima.2025.100263

Sameed Khan , Richard Lartey , Nancy Obuchowski , Sibaji Gaj , Jeehun Kim , Mei Li , Brendan Eck , Faysal Altahawi , Morgan H. Jones , Laura Huston , Kevin Harkins , Michael Knopp , Christopher Kaeding , Carl Winalski , Kurt Spindler , Xiaojuan Li

Objective

The infrapatellar fat pad (IPFP) has been identified as a potential agent in joint degeneration leading to post-traumatic osteoarthritis (PTOA) in patients suffering from anterior cruciate ligament (ACL) injury. We leveraged machine learning and radiomics methods on knee MRI taken at ten-year follow-up post-ACL reconstruction to associate IPFP with knee symptoms and radiographic PTOA.

Design

In this cross-sectional study, the multi-site NIH-funded MOON nested Onsite cohort was followed up at ten years to obtain 3D MRI radiomics and patient-reported outcome measures (PROM). We identified the features with two radiomics-based classifiers that can detect, respectively, knee symptoms based on PROM data or radiographic PTOA based on Kellgren-Lawrence grade.

Results

We identified 29 radiomics features describing IPFP texture heterogeneity, volume, and signal intensity. For knee symptom detection, models constructed from radiomics achieved an AUROC of 0.76 [95 % CI, 0.65, 0.87], and 0.74 on cross-validation and the test set, respectively. For radiographic PTOA detection, models combining radiomics with clinical features achieved an AUROC of 0.82 [95 % CI, 0.74, 0.92] and 0.79 on cross-validation and the test set, respectively. Increased IPFP texture heterogeneity, larger volume, and increased signal intensity were linked to higher likelihood of knee symptoms and radiographic PTOA.

Conclusion

Radiomics features describing IPFP intensity, morphology, and texture achieve fair to moderate performance in discriminating PTOA-positive from PTOA-negative patients, defined either symptomatically or radiographically. These features describe the relationship between the IPFP and PTOA and are candidates for prognostic models or diagnostic scores that would link knee imaging to patient symptoms.

目的髌下脂肪垫（IPFP）被认为是导致前交叉韧带（ACL）损伤患者发生外伤性骨关节炎（PTOA）的潜在因素。我们利用机器学习和放射组学方法对前交叉韧带重建后随访10年的膝关节MRI进行分析，将IPFP与膝关节症状和x线摄影上的PTOA联系起来。在这项横断面研究中，美国国立卫生研究院资助的多地点MOON嵌套现场队列每10年随访一次，以获得3D MRI放射组学和患者报告的结果测量（PROM）。我们用两种基于放射组学的分类器来识别特征，这两种分类器分别可以检测膝关节症状，基于PROM数据或基于kelgren - lawrence分级的x线摄影pta。结果我们确定了29个描述IPFP纹理异质性、体积和信号强度的放射组学特征。对于膝关节症状检测，放射组学构建的模型在交叉验证和测试集上的AUROC分别为0.76[95 % CI, 0.65, 0.87]和0.74。对于放射学pta检测，结合放射组学和临床特征的模型在交叉验证和测试集上的AUROC分别为0.82[95 % CI, 0.74, 0.92]和0.79。IPFP质构不均匀性增加、体积增大和信号强度增加与膝关节症状和x线上睑下垂的可能性增加有关。结论放射组学特征描述了IPFP强度、形态和质地，在区分pta阳性和pta阴性患者方面达到了一般到中等的效果，无论是从症状上还是从影像学上定义。这些特征描述了IPFP和PTOA之间的关系，是将膝关节成像与患者症状联系起来的预后模型或诊断评分的候选对象。

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