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J Magn Reson Imaging. 2018 Nov;48(5):1344-1350. doi: 10.1002/jmri.26174. Epub 2018 May 7.

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

Author information

1
Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
2
Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
3
Biomedical Imaging Group Rotterdam, Departments of Medical Informatics & Radiology, Erasmus MC, Rotterdam, The Netherlands.
4
Quantitative Imaging, Department of Imaging Physics, TU Delft, Delft, The Netherlands.
5
Department of Sports Medicine, Medical Center Haaglanden, Leidschendam, The Netherlands.
6
Department of Orthopedics Erasmus MC, University Medical Center, Rotterdam, The Netherlands.

Abstract

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 (kep and ktrans ) were calculated from motion-compensated DCE-MRI data by fitting Tofts' model. Weighted mean and unweighted median values of kep and ktrans 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 ktrans , and 0.046 (95% CI -0.021; 0.11) and 0.069 (95% CI -0.017; 0.15) for kep , respectively. All perfusion parameters were not significantly different between groups (P-values: 0.32; 0.47 for ktrans , and 0.24; 0.15) for kep . However, a significant difference in variance between populations was observed for ktrans (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 ktrans variance, warrant further research.

LEVEL OF EVIDENCE:

1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1344-1350.

KEYWORDS:

knee; magnetic resonance imaging; patella; patellofemoral pain syndrome; perfusion imaging

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