The Value Of T2 Mapping And T2~* Mapping In The Diagnosis Of Knee Cartilage Injury In New-onset Type 2 Diabetes Mellitus

ObjectiveDiabetes mellitus(DM)and Osteoarthritis(OA)have been proved to be common related diseases and DM may have adverse effects on articular cartilage.In China,the incidence of Type II diabetes mellitus(T2DM)is more than 90%.At present,the main method for non-invasive examination of cartilage is magnetic resonance imaging(MRI)scanning and quantitative MRI can be used to reflect the changes of biochemical structure of cartilage and to make the minor degeneration of cartilage could be visible.The purpose of this study was to investigate the ability of T2 mapping and T2~*mapping in the diagnosis of knee cartilage injury in patients with new-onset T2DM and to discuss whether the knee cartilage injury was improved after the treatment of diabetes.In addition,the correlation between T2 and T2~*values of knee cartilage and fasting blood glucose in new-onset T2DM patients were also be observed.MethodsFrom November 2020 to January 2022,the patients with new-onset T2DM diagnosed by the Department of Endocrinology of the first affiliated Hospital of Jinan University were collected.Thirty-six patients(70 knees in total)were included in our study.Eighteen patients(35 knee joints)with newly diagnosed T2DM were selected as the experimental group,and 18 healthy volunteers(35 knee joints)were group-matched with the experimental group patients.The patients in the experimental group were followed up for 3 months after diabetes treatments and 11 patients(21 knees in total)who underwent the second MRI examination after treatment were taken as the re-examined group.The new-onset T2DM patients,normal controls and re-examined patients were scanned with 3.0 T MRI for T2 mapping and T2~*mapping sequence.The cartilage of each knee was divided into five compartments,including patella(PAT),medial femoral condyle(MF),lateral femoral condyle(LF),medial tibia(MT),and lateral tibia(LT).The MRI images were processed in GE post-processing workstation,and the T2 and T2~*values of each cartilage compartment of patients were measured.The modified WORMS semi-quantitative scoring system was used to grade the surface features of the knee joint,such as cartilage and meniscus.The differences of T2 and T2~*values were compared between the new-onset T2DM patients and normal controls as well as the experimental group and the re-examined group.We also observed the correlation between the T2 and T2~*values of knee cartilage and fasting blood glucose in new-onset T2DM patients.ResultsThe T2 values of MF,MT,LT and overall knee joint(the mean value of all cartilage compartments)in new-onset T2DM group were significantly higher than those in the normal control group.The T2~*values of the MF,LF,MT and overall knee joint in the experimental group were significantly lower than those in the healthy controls.After the treatment of diabetes,The T2 values of MF,MT and overall knee joint of new-onset T2DM patients were lower than those of the first scan(p<0.05).The T2~*values of MF,MT,LT,PAT and overall knee joint were higher than those of the first scan(p<0.05).The T2 mapping and T2~*mapping pseudo-color images of knee cartilages generated by GE post-processing software package showed that the layered structure of knee cartilage in the new-onset T2DM group were less clear,while the multilayer structure of cartilage in the healthy control group were distinct and the signal were uniform.After3 months of diabetes treatment,the pseudo-color of multilayer structure of cartilage in the patient was more uniform than that of T2 mapping and T2~*mapping images before treatment.There were no correlations between T2 and T2~*values of knee cartilage and fasting blood glucose in new-onset T2DM patients.ConclusionT2 mapping and T2~*mapping can effectively reflect the biochemical structural changes of knee cartilage in patients with new-onset T2DM,which are related to cartilage injury.And the treatment of diabetes can shorten the T2 or prolong the T2~*value of cartilage,indicating that hypoglycemic therapy can affect the biochemical structure of cartilage,and to provide ideas for the treatment of diabetes-related osteoarthritis.