Shear wave elastografi ve t2* haritalamanın erken evre troklear kıkırdak hasarı tanısına katkısı
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Tarih
2021
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Düzce Üniversitesi
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info:eu-repo/semantics/openAccess
Özet
ÖZET Amaç: Erken diz patellofemoral osteoartrit hastalarında femoral troklear kıkırdağı MR T2* haritalama ve ultrason shear wave elastografi yöntemlerini kullanarak incelemek ve bu iki tekniğin tanıya katkısını değerlendirmektir. Gereç ve Yöntem: Teknik değerlendirmeler Düzce Üniversitesi Tıp Fakültesi Radyoloji Anabilim Dalı'nda Siemens marka 3T MRG cihazı (Siemens Magnetom Skyra, Germany) ile herhangi bir nedenle klinik branşlar tarafından istenilen diz MRG incelemeleri üzerinden prospektif olarak yapıldı. MRG'de troklear kıkırdak yapısı değerlendirilerek normal bulguları olan 41 olgu ve erken kartilaj hasarı bulguları olan 41 olguya MRG T2* haritalama, gri skala ultrason ve VTQ/ARFI yöntemiyle shear wave elastografi yapıldı. Troklear kıkırdakta T2* haritalamada relaksasyon zamanı ölçümleri aksiyel planda medial kondil (MK), lateral kondil (LK) ve interkondiler (İK) alandan olmak üzere 3 bölgeden 5 mm2 ROI'ler kullanılarak aynı kesit alanından 3 değer ölçülerek ortalamaları kaydedildi. Shear wave elastografi yönteminde troklear kıkırdak shear wave hız ölçümleri aksiyel planda MK, LK ve İK alandan olmak üzere 3 bölgeden önceden belirlenmiş 5x5 mm'lik ROI'ler kullanılarak aynı kesit alanından 3 değer ölçülerek ortalamaları kaydedildi. Her iki inceleme için de troklear kıkırdağın MK, LK ve İK bölgeden kalınlıkları ölçüldü. Bulgular: Ultrasonda kıkırdak kalınlıkları açısından gruplar arasında istatistiksel olarak anlamlı düzeyde farklılık saptandı. Kıkırdak kalınlıklarının çalışma grubunda normal gruba göre MK (p=0,002), İK (p=0,002) ve LK'de (p=0,001) istatistiksel olarak anlamlı düzeyde yüksek değerler oldukları gözlendi. MRG incelemede kıkırdak kalınlıkları açısından gruplar arasında istatistiksel olarak anlamlı düzeyde farklılık saptandı. Kıkırdak kalınlıklarının çalışma grubunda normal gruba göre MK (p=0,003), İK (p=0,001) ve LK'de (p=0,001) istatistiksel olarak anlamlı düzeyde yüksek değerler ölçüldü. Shear wave hız değeri açısından gruplar arasında istatistiksel olarak anlamlı düzeyde farklılık izlendi. Shear wave hız değerinin çalışma grubunda normal gruba göre MK (p=0,023), İK (p=0,001) ve LK'de (p=0,753) istatistiksel olarak anlamlı düzeyde düşük değerler ölçüldü. T2* haritalama değeri açısından gruplar arasında istatistiksel olarak anlamlı düzeyde farklılık gözlendi. T2* haritalama değerinin çalışma grubunda normal gruba göre MK (p=0,001), İK (p=0,001) ve LK'de (p=0,001) istatistiksel olarak anlamlı düzeyde yüksek değerler oldukları tespit edildi. Sonuç: Çalışmamızda erken kartilaj hasarı bulguları olan grupta hem gri skala ultrason hem de MRG'de kıkırdak kalınlığında artış izlenmiştir. Patolojik grupta kıkırdaktaki yumuşamaya sekonder shear wave hız değerlerinde düşüş ve T2* haritalamada transvers relaksasyon zamanında uzama görülmüştür. Shear wave elastografi ve MRG T2* haritalama tekniklerinin diz OA hastalarında özellikle erken evrede troklear kıkırdaktaki değişiklerin değerlendirilmesinde güvenilir yöntemler olduğu sonucuna varılmıştır.
SUMMARY Objective: To examine femoral trochlear cartilage in patients with early knee osteoarthritis using MRI T2 * Mapping and Ultrasound Shear wave elastography methods and to evaluate the contribution of these two techniques to diagnosis. Materials and Methods: Technical evaluations were carried out prospectively by using Siemens brand 3T MRI device in the Department of Radiology over knee MRI examinations requested by clinical branches for any reason. By evaluating the trochlear cartilage structure in MRI, 41 cases with normal findings and 41 cases with early osteoarthritis findings were performed MRI T2 * Mapping, gray scale Ultrasound and Shear wave elastography with VTQ / ARFI method. T2 * in trochlear cartilage, relaxation time measurements were measured from 3 regions, medial condyle (MC), lateral condyle (LK) and intercondylar (IC) area in the axial plane, using 5 mm2 ROIs from the same cross-sectional area and their averages were recorded. In the Shear wave elastography method, trochlear cartilage Shear wave velocity measurements were measured from 3 regions, including MK, LK and IC area in the axial plane, using pre-determined 5x5 mm ROIs and 3 values were measured from the same cross-sectional area and their averages were recorded. For both examinations, thicknesses of the trochlear cartilage from the MC, LK and IC region were measured. Results: A statistically significant difference was observed between the groups in terms of cartilage thickness on ultrasound. It was observed that the cartilage thicknesses were significantly higher in the study group compared to the normal group in MK (p=0.002), IC (p=0.002) and LK (p=0.001). A statistically significant difference was observed between the groups in terms of cartilage thickness in MRI. It was observed that the cartilage thicknesses were significantly higher in the study group compared to the normal group in MK (p=0.003), HR (p=0.001) and LK (p=0.001). A statistically significant difference was observed between the groups in terms of shear wave velocity values. It was observed that the shear wave velocity values were significantly lower in MK (p=0.023), IC (p=0.001) and LK (p=0.753) in the study group compared to the normal group. A statistically significant difference was observed between the groups in terms of T2 * mapping value. It was observed that T2 * mapping value was significantly higher in MK (p=0.001), HR (p=0.001) and LK (p= 0.001) in the study group compared to the normal group. Conclusion: In our study, an increase in cartilage thickness was observed in both ultrasound and MRI in the group with early findings of osteoarthritis. In the pathological group, a decrease in Shear wave velocity values secondary to softening in the cartilage and prolongation in T2 * mapping were observed. It has been concluded that shear wave elastography and MRI T2 * mapping techniques are reliable methods in evaluating the changes in the trochlear cartilage, especially in the early stages of knee OA patients.
SUMMARY Objective: To examine femoral trochlear cartilage in patients with early knee osteoarthritis using MRI T2 * Mapping and Ultrasound Shear wave elastography methods and to evaluate the contribution of these two techniques to diagnosis. Materials and Methods: Technical evaluations were carried out prospectively by using Siemens brand 3T MRI device in the Department of Radiology over knee MRI examinations requested by clinical branches for any reason. By evaluating the trochlear cartilage structure in MRI, 41 cases with normal findings and 41 cases with early osteoarthritis findings were performed MRI T2 * Mapping, gray scale Ultrasound and Shear wave elastography with VTQ / ARFI method. T2 * in trochlear cartilage, relaxation time measurements were measured from 3 regions, medial condyle (MC), lateral condyle (LK) and intercondylar (IC) area in the axial plane, using 5 mm2 ROIs from the same cross-sectional area and their averages were recorded. In the Shear wave elastography method, trochlear cartilage Shear wave velocity measurements were measured from 3 regions, including MK, LK and IC area in the axial plane, using pre-determined 5x5 mm ROIs and 3 values were measured from the same cross-sectional area and their averages were recorded. For both examinations, thicknesses of the trochlear cartilage from the MC, LK and IC region were measured. Results: A statistically significant difference was observed between the groups in terms of cartilage thickness on ultrasound. It was observed that the cartilage thicknesses were significantly higher in the study group compared to the normal group in MK (p=0.002), IC (p=0.002) and LK (p=0.001). A statistically significant difference was observed between the groups in terms of cartilage thickness in MRI. It was observed that the cartilage thicknesses were significantly higher in the study group compared to the normal group in MK (p=0.003), HR (p=0.001) and LK (p=0.001). A statistically significant difference was observed between the groups in terms of shear wave velocity values. It was observed that the shear wave velocity values were significantly lower in MK (p=0.023), IC (p=0.001) and LK (p=0.753) in the study group compared to the normal group. A statistically significant difference was observed between the groups in terms of T2 * mapping value. It was observed that T2 * mapping value was significantly higher in MK (p=0.001), HR (p=0.001) and LK (p= 0.001) in the study group compared to the normal group. Conclusion: In our study, an increase in cartilage thickness was observed in both ultrasound and MRI in the group with early findings of osteoarthritis. In the pathological group, a decrease in Shear wave velocity values secondary to softening in the cartilage and prolongation in T2 * mapping were observed. It has been concluded that shear wave elastography and MRI T2 * mapping techniques are reliable methods in evaluating the changes in the trochlear cartilage, especially in the early stages of knee OA patients.
Açıklama
Anahtar Kelimeler
Radyoloji ve Nükleer Tıp, Radiology and Nuclear Medicine, Osteoartrit, Shear wave elastografi, Troklear kıkırdak, T2* haritalama, MRG, Osteoarthritis, Shear wave elastography, Trochlear cartilage, T2 * mapping, MRI
