Blood perfusion of patellar bone measured by dynamic contrast‐enhanced MRI in patients with patellofemoral pain: A case–control study

BACKGROUND: Altered perfusion might play an important role in the pathophysiology of patellofemoral pain (PFP), a common knee complaint with unclear pathophysiology. PURPOSE: To investigate differences in dynamic contrast‐enhanced (DCE)‐MRI perfusion parameters between patients with PFP and healthy...

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Detalles Bibliográficos
Autores principales: van der Heijden, Rianne A., Poot, Dirk H.J., Ekinci, Melek, Kotek, Gyula, van Veldhoven, Peter L.J., Klein, Stefan, Verhaar, Jan A.N., Krestin, Gabriel P., Bierma‐Zeinstra, Sita M.A., van Middelkoop, Marienke, Oei, Edwin H.G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Original Research
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221059/
https://www.ncbi.nlm.nih.gov/pubmed/29734499
http://dx.doi.org/10.1002/jmri.26174
Descripción
Sumario:BACKGROUND: Altered perfusion might play an important role in the pathophysiology of patellofemoral pain (PFP), a common knee complaint with unclear pathophysiology. PURPOSE: To investigate differences in dynamic contrast‐enhanced (DCE)‐MRI perfusion parameters between patients with PFP and healthy control subjects. POPULATION/SUBJECTS/PHANTOM/SPECIMEN/ANIMAL MODEL: Thirty‐five adult patients with PFP and 44 healthy adult control subjects. FIELD STRENGTH/SEQUENCE: 3T DCE‐MRI consisting of a sagittal, anterior‐posterior, frequency‐encoded, fat‐suppressed 3D spoiled gradient‐echo sequence with intravenous contrast administration. ASSESSMENT: Patellar bone volumes of interest (VOIs) were delineated by a blinded observer. Quantitative perfusion parameters (k(ep) and k(trans)) were calculated from motion‐compensated DCE‐MRI data by fitting Tofts' model. Weighted mean and unweighted median values of k(ep) and k(trans) were computed within the patellar bone VOIs. STATISTICAL TESTS: Differences in patellar bone perfusion parameters were compared between groups by linear regression analyses, adjusted for confounders. RESULTS: Mean differences of weighted mean and unweighted median were 0.0039 (95% confidence interval [CI] –0.0013; 0.0091) and 0.0052 (95% CI –0.0078; 0.018) for k(trans), and 0.046 (95% CI –0.021; 0.11) and 0.069 (95% CI –0.017; 0.15) for k(ep), respectively. All perfusion parameters were not significantly different between groups (P‐values: 0.32; 0.47 for k(trans), and 0.24; 0.15) for k(ep). However, a significant difference in variance between populations was observed for k(trans) (P‐value 0.007). DATA CONCLUSION: Higher patellar bone perfusion parameters were found in patients with PFP when compared to healthy control subjects, but these differences were not statistically significant. This result, and the observed significant difference in k(trans) variance, warrant further research. Level of Evidence: 1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1344–1350.

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