Evaluation of subchondral bone marrow lipids of acute anterior cruciate ligament (ACL)-injured patients at 3 T.
OBJECTIVE
The objectives of this study were to investigate the changes in compartment-specific subchondral bone marrow lipids of femoral-tibial bone in acute anterior cruciate ligament (ACL)-injured patients compared to that of healthy volunteers and patients with osteoarthritis (OA) (Kellgren-Lawrence [KL] grade 2-3).


METHODS
A total of 55 subjects were recruited in the study and subdivided into three subgroups: 17 healthy controls (4 females, 13 males; mean age = 41 ± 16, age range 24-78 years), 17 patients with acute ACL injury (3 females, 14 males; mean age = 30 ± 11, age range 18-61 years), and 21 patients with KL2-3 OA (12 females, 9 males; mean age = 65 ± 12, age range 44-89 years). Routine clinical proton density-weighted fast spin echo images in sagittal (without fat saturation), axial, and coronal (fat saturation) planes were acquired on a 3 T clinical scanner for cartilage morphology using Whole-Organ Magnetic Resonance Imaging Score grading. A voxel of 10 × 10 × 10 mm(3) was positioned in the medial and lateral compartments of the tibia and femur for proton magnetic resonance spectroscopy measurements using the single voxel stimulated echo acquisition mode pulse sequence. All proton magnetic resonance data were processed with Java-based magnetic resonance user interface. Wilcoxon rank sum test and mixed model two-way analysis of variance were performed to determine significant differences between different compartments and examine the effect of ACL injury, OA grade and compartment, and their interactions.


RESULTS
The index of unsaturation in lateral tibial compartment in ACL-injured patients was significantly higher (P < .05) than all compartments except lateral femoral in patients with KL2-3 OA. Significantly lower values (P < .05) were also identified in saturated lipids at 2.03 ppm in all compartments in ACL-injured patients than those of all compartments in patients with KL2-3 OA.


CONCLUSIONS
The preliminary results suggest that the indices of unsaturation in the lateral tibial compartment and the peaks of saturated lipids at 1.3 and 2.03 ppm in medial tibial compartment may be clinically useful to characterize subchondral bone marrow among healthy controls, acute ACL-injured patients, and patients with OA.
Department of Radiology, Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, New York University Langone Medical Center, 660 First Avenue, 4th Floor, New York, NY 10016; School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou, Jiangsu Province, China; School for Radiological and Interdisciplinary Sciences (RAD-X), Soochow University, Suzhou, Jiangsu Province, China. Electronic address: bastion@163.com.
Ligong
L
Wang
Research Collaborations, MR Spectroscopy, Siemens Healthcare, Malvern, PA.
Nouha
N
Salibi
Department of Radiology, Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, New York University Langone Medical Center, 660 First Avenue, 4th Floor, New York, NY 10016.
Gregory
G
Chang
Department of Radiology, Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, New York University Langone Medical Center, 660 First Avenue, 4th Floor, New York, NY 10016.
Jenny T
JT
Bencardino
Department of Radiology, Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, New York University Langone Medical Center, 660 First Avenue, 4th Floor, New York, NY 10016.
James S
JS
Babb
Department of Orthopaedic Surgery, New York University Langone Medical Center, NY.
Andrew
A
Rokito
Department of Orthopaedic Surgery, New York University Langone Medical Center, NY.
Laith
L
Jazrawi
Department of Orthopaedic Surgery, New York University Langone Medical Center, NY.
Orrin
O
Sherman
Department of Radiology, Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, New York University Langone Medical Center, 660 First Avenue, 4th Floor, New York, NY 10016.
Ravinder R
RR
Regatte
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016118:Anterior Cruciate Ligament / Q000378:metabolism* / Q000473:pathology; D000070598:Anterior Cruciate Ligament Injuries; D001853:Bone Marrow / Q000378:metabolism* / Q000473:pathology; D005260:Female; D005269:Femur / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007718:Knee Injuries / Q000378:metabolism* / Q000473:pathology; D050356:Lipid Metabolism / Q000502:physiology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000378:metabolism / Q000473:pathology; D018709:Statistics, Nonparametric; D013977:Tibia / Q000378:metabolism / Q000473:pathology; D055815:Young Adult
Proton MR spectroscopy; anterior cruciate ligament injury; bone marrow lipids; lipid metabolism; osteoarthritis