定量动态对比增强磁共振分析成人髋关节骨髓血流灌注的研究

目的探讨成人髋关节动态对比增强磁共振(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)定量参数与部位、年龄和性别的相关性。材料与方法回顾性分析168例患者髋关节不同部位(髋臼、股骨头骺线上方区域、股骨干骺端)的DCE-MRI定量参数(容积转运常数K~(trans)、速率常数K_(ep)和血管外细胞外间隙容积分数V_e)。采用Kruskal-Wallis秩和检验比较髋关节不同部位灌注参数值差异,对年龄、髋关节不同部位灌注参数进行Spearman相关性分析,采用Wilcoxon秩和检验比较50岁及以下和50岁以上人群中男女髋关节不同部位灌注参数的差异。结果 168例患者中,男88例,平均59.97岁(22~89岁),女80例,平均57.69岁(21~85岁)。DCE定量灌注参数分析结果显示髋关节不同部位K~(trans)、K_(ep)、V_e值的差异均有统计学意义(P值均0.05)。男女年龄与髋臼K~(trans)、K_(ep)、V_e值呈负相关(男性r_s为-0.532,-0.476,-0.319,女性为-0.566,-0.387,-0.406);男性年龄和股骨头骺线上方区域V_e值呈负相关,r_s为-0.152,女性年龄和股骨头骨骺Ksep呈正相关,r_s为0.282;女性年龄和股骨干骺端K~(tran)、K_(ep)负相关,r_s为分别为-0.200,-0.297;以上P值均0.05。≤50岁人群中,男女髋臼和股骨干骺端K~(trans)、K_(ep)、V_e值的差异有统计学意义(P值均0.05);50岁人群中,除髋臼、股骨头骺线上方区域V_e值差异无统计学意义,余参数的差异均有统计学意义(P值0.05)。结论 DCE-MRI能够获得髋关节骨髓灌注的定量参数(K~(trans)、K_(ep)、V_e)。部位、性别、年龄对髋关节的灌注参数均有影响。

Value of quantitative dynamic contrast-enhanced MRI in the evaluation of bone marrow perfusion in the adult hip

Objective:To evaluate the bone marrow perfusion in the adult hip at quantitative dynamic contrast-enhanced MRI (DCE-MRI) with regard to sex,age and skeletal site.Materials and Methods:This retrospective study includes 168 patients who underwent DCE-MRI.Quantitative parameters Ktrans,Kep,Ve were calculated in the acetabulum,femoral epiphysis and metaphysis.The parameters at different regions were compared by Kruskal-Wallis test.The correlations between age and quantitative parameters in different sites were calculated using Spearman rank coefficient analysis in men and women respectively.Patients were then stratified into two groups,those 50 years or younger and those older than 50 years old.Perfusion parameters in different locations between different genders were compared by using the Wilcoxon signed-rank tests in each age group.Results:This study includes 168 patients (88 men,mean age,59.97 years age range,22-89 years],80 women,mean age 57.69 years age range,21-85 years]).A significant difference (P＜0.05) in Ktrans,Kep,Ve was found among different skeletal sites.There was a significant correlation between age and Ktrans,Kep,Ve of the acetabulum (Spearman rs=-0.532,-0.476,-0.319 in men and-0.566,-0.387,-0.406 in women respectively),between age and Ve of femoral epiphysis in men (rs=-0.152),between age and Kep of femoral epiphysis in women (rs=0.282),between age and Ktrans,Kep of femoral metaphysis in women (rs=-0.200,-0.297),P＜0.05.The Ktrans,Kep,Ve of the acetabulum and femoral metaphysis were significantly different between males and females in patients younger than 50 (P＜0.05).Males and females revealed no difference for Ve of the acetabula and femoral epiphysis in patients older than 50 years old (P＞0.05),while other parameters were statistically different (P＜0.05).Conclusions:DCE-MRI is a technique that acquires perfusion parameters in the hip non-invasively quantitatively.Bone marrow perfusion parameters in the adult hip are influenced by location,gender and age.