Preliminary Application Of Intravoxel Incoherent Motion Imaging In Bone Marrow Lesions Of Knee Osteoarthritis

Purpose:Intravoxel Incoherent Motion(IVIM)imaging uses different quantitative parameters to explore the diffusion and perfusion of bone marrow lesions(BMLs)in knee osteoarthritis(OA).Materials and Methods:This study collected subjects from the outpatient and inpatient departments of our hospital from March 2020 to October 2020.A total of 41 subjects were collectedin this study,6 cases were excluded,and 35 subjects(mean age 56.1 ±10.8years;age range:40-93 years)were includedfinally,including 21 cases of BMLs and 14 cases without BMLs,with a total of 50 knee joints.In this study,all subjects used 3.0T high-field magnetic resonance imaging and knee joint special coil for image acquisition.BMLswas identified and diagnosed by doctors in the senior bone muscle radiology group,and then the knee joint was divided into 15 subregions for BMLs classification according to the Knee Osteoarthritis Scoring System(KOSS).The IVIM-related parameters of BMLs negative and positive regions are measured by drawing the region of interest,including D value,D* value,f value and ADC value,and statistical analysis is carried out.Results:Among the 750 knee joint subregions,91(12.1%)were positive for BMLs and 659(87.9%)were negative for BMLs.The IVIM related parameters of positive BMLs and negative BMLs were analyzed,and there were significant differences in D value,D* value,f value and ADC value.The IVIM related parameters of positive and negative BMLs in different parts were analyzed,and it was found that there were significant differences in D value,f value and ADC value of patella,but there was no significant difference in D* value.There were significant differences in D value,D* value,f value and ADC value between femur and tibia.The area under the ROC curve and the confidence interval of BMLs are: D value 0.957(0.929,0.985),D* value 0.201(0.098,0.303),f value 0.904(0.857,0.951),ADC value 0.967(0.943,0.992).Conclusion: IVIM evaluated the diffusion and perfusion in BMLs area of knee osteoarthritis.It was found that D value,f value and ADC value had higher sensitivity and specificity.D value and ADC value had the potential to predict the decrease of osteocytes in BMLs region,and f value had the potential to predict the increase of angiogenesis in BMLs region,which indicated that IVIM imaging was helpful to further understand the mechanism of BMLs in early knee OA.