Perfusion in bone marrow lesions assessed on DCE-MRI and its association with pain in knee osteoarthritis: a cross-secti
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SCIENTIFIC ARTICLE
Perfusion in bone marrow lesions assessed on DCE-MRI and its association with pain in knee osteoarthritis: a cross-sectional study Cecilie L Daugaard 1,2 & Robert GC Riis 3 & Elisabeth Bandak 1 & Henrik Gudbergsen 1 & Marius Henriksen 1,4 & Henning Bliddal 1 & Mikael Boesen 1,2 Received: 7 August 2019 / Revised: 27 October 2019 / Accepted: 28 October 2019 # ISS 2019
Abstract Objective To investigate the association between pain and perfusion in bone marrow lesions with and without cysts assessed dynamic contrast-enhanced (DCE)-MRI in patients with knee osteoarthritis. Subjects and methods In a cross-sectional setting, perfusion in bone marrow lesions was assessed using 3 Tesla MRI and correlated (Spearman’s rank correlation) to pain using the knee injury and osteoarthritis outcome score (KOOS). Bone marrow lesions were assessed across the whole knee with DCE-MRI using heuristic variable and non-contrast-enhanced-MRI using MRI osteoarthritis knee score. Results Data were available from 107 participants. The participants had a mean age of 60.8 years, mean BMI of 34.5 kg/m2, mean KOOS-pain of 63.7 (0–100 scale), and mean bone marrow lesion sum score of 6.5 (0–45 scale). The bivariate association between KOOS-pain and the heuristic perfusion variable time to peak in bone marrow lesions containing subchondral cysts showed a statistically significant correlation (r = 0.40; p = 0.002). The perfusion variables were not correlated with KOOS-pain in bone marrow lesions without cysts. Conclusion In this cross-sectional study, the rate of perfusion (TTP) in bone marrow lesions containing subchondral cysts was associated with pain in patients with knee OA. DCE-MRI has a potential to be used for separating subtypes of OA. Keywords Knee osteoarthritis . Pain . MRI perfusion imaging . Dynamic contrast-enhanced magnetic resonance imaging
Abbreviations BMI Body mass index BML Bone marrow lesion DCE-MRI Dynamic contrast-enhanced MRI Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00256-019-03336-4) contains supplementary material, which is available to authorized users. * Mikael Boesen [email protected]; [email protected] 1
The Parker Institute, Copenhagen University Hospital Bispebjerg-Frederiksberg, Copenhagen, Denmark
2
Department of Radiology, Copenhagen University Hospital Bispebjerg-Frederiksberg, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
3
4
Department of Radiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark Department of Physical and Occupational Therapy, Copenhagen University Hospital Bispebjerg-Frederiksberg, Copenhagen, Denmark
eGFR IRE KLG KOOS ME MOAKS MRI non-CE MRI OA TTP Vol.Voxel
Estimated glomerular filtration rate Initial rate of enhancement Kellgren Lawrence grade Knee injury and osteoarthritis outcome score Maximum enhancement MRI osteoarthritis knee score Magnetic resonance imaging Non-contrast-enhanced MRI Osteoarthritis Time to peak The volume (ml) of voxels with “plateau” or “washout”
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