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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.

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