title: Perfusion of subchondral bone marrow in knee osteoarthritis: A dynamic contrast-enhanced magnetic resonance imaging preliminary study.
abstract: The role of inflammation in the pathogenesis of osteoarthritis is being given major interest, and inflammation is closely linked with vascularization. It was recently demonstrated that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) could identify the subchondral bone marrow vascularization changes occurring in osteoarthritis in animals. These changes appeared before cartilage lesions were visible and were correlated with osteoarthritis severity. Thus the opportunity to obtain an objective assessment of bone vascularization in non-invasive conditions in humans might help better understanding osteoarthritis pathophysiology and finding new biomarkers. We hypothesized that, as in animals, DCE-MRI has the ability to identify subchondral bone marrow vascularization changes in human osteoarthritis. We performed knee MRI in 19 patients with advanced knee osteoarthritis. We assessed subchondral bone marrow vascularization in medial and lateral femorotibial compartments with DCE-MRI and graded osteoarthritis lesions on MR images. Statistical analysis assessed intra- and inter-observer agreement, compared DCE-MRI values between the different subchondral zones, and sought for an influence of age, sex, body mass index, and osteoarthritis garde on these values. The intra- and inter-observer agreement for DCE-MRI values were excellent. These values were significantly higher in the femorotibial compartment the most affected by osteoarthritis, both in femur and tibia (p<0.0001) and were significantly and positively correlated with cartilage lesions (p=0.02) and bone marrow oedema grade (p<0.0001) after adjustment. We concluded that, as in animals, subchondral bone marrow vascularization changes assessed with DCE-MRI were correlated with osteoarthritis severity in humans.
authors.affiliation: Lille Catholic Hospitals, Imaging Department, Lille Catholic University, Lille, France; PMOI Physiopathology of Inflammatory Bone Diseases, EA 4490, Lille, France. Electronic address: Budzik.jean-francois@ghicl.net.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Budzik
authors.affiliation: Lille Catholic Hospitals, Imaging Department, Lille Catholic University, Lille, France. Electronic address: Ding.juliette@gmail.com.
authors.forename: Juliette
authors.initials: J
authors.lastname: Ding
authors.affiliation: Lille Catholic Hospitals, Biostatistics Department, Lille Catholic University, Lille, France. Electronic address: Norberciak.Laurene@ghicl.net.
authors.forename: Laurène
authors.initials: L
authors.lastname: Norberciak
authors.affiliation: Lille Catholic Hospitals, Rheumatology Department, Lille Catholic University, Lille, France. Electronic address: Pascart.tristan@ghicl.net.
authors.forename: Tristan
authors.initials: T
authors.lastname: Pascart
authors.affiliation: EA4708 I3MTO, Orleans Regional Hospital, University of Orleans, Orleans, France. Electronic address: hechmi.toumi@univ-orleans.fr.
authors.forename: Hechmi
authors.initials: H
authors.lastname: Toumi
authors.affiliation: Lille Catholic Hospitals, Imaging Department, Lille Catholic University, Lille, France. Electronic address: Verclytte.Sebastien@ghicl.net.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Verclytte
authors.affiliation: Lille Catholic Hospitals, Orthopaedic Surgery Department, Lille Catholic University, Lille, France. Electronic address: Coursier.Raphael@ghicl.net.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Coursier
mesh_terms: D000368:Aged; D000818:Animals; D001853:Bone Marrow / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D005260:Female; D005269:Femur / Q000473:pathology; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging* / Q000473:pathology; D011446:Prospective Studies; D012720:Severity of Illness Index; D013977:Tibia / Q000473:pathology
chemical_list: D003287:Contrast Media
keywords: Bone; Bone marrow; Knee; Magnetic resonance imaging; Osteoarthritis