Blood perfusion of patellar bone measured by dynamic contrast-enhanced MRI in patients with patellofemoral pain

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

van der Heijden, R.A.J. (Erasmus MC)
Poot, D.H.J. (TU Delft ImPhys/Quantitative Imaging; Erasmus MC)
Ekinci, Melek (Erasmus MC)
Kotek, Gyula (Erasmus MC)
van Veldhoven, Peter L.J. (Haaglanden Medical Center)
Klein, S. (Erasmus MC)
Verhaar, Jan A.N. (Erasmus MC)
Krestin, Gabriel P. (Erasmus MC)
Bierma-Zeinstra, Sita M.A. (Erasmus MC)
van Middelkoop, Marienke (Erasmus MC)
Oei, Edwin H.G. (Erasmus MC)

2018

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.

knee
magnetic resonance imaging
patella
patellofemoral pain syndrome
perfusion imaging

http://resolver.tudelft.nl/uuid:bd2b4679-e081-479c-b4c1-b1bfddce937d

https://doi.org/10.1002/jmri.26174

1053-1807

Journal of Magnetic Resonance Imaging, 48 (5), 1344-1350

Institutional Repository

journal article

© 2018 R.A.J. van der Heijden, D.H.J. Poot, Melek Ekinci, Gyula Kotek, Peter L.J. van Veldhoven, S. Klein, Jan A.N. Verhaar, Gabriel P. Krestin, Sita M.A. Bierma-Zeinstra, Marienke van Middelkoop, Edwin H.G. Oei