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Blood perfusion of patellar bone measured by dynamic contrast‐enhanced MRI in patients with patellofemoral pain: A case–control study
Author(s) -
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.,
BiermaZeinstra Sita M.A.,
van Middelkoop Marienke,
Oei Edwin H.G.
Publication year - 2018
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.26174
Subject(s) - medicine , perfusion , confidence interval , nuclear medicine , confounding , dynamic contrast enhanced mri , pathophysiology , population , magnetic resonance imaging , radiology , environmental health
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.