Application of multimodal magnetic resonance imaging in the study of pathological mechanism of microcirculation and fat content in steroid-induced osteonecrosis of the femoral head

doi:10.3877/cma.j.issn.1673-9450.2020.02.008

Abstract

Abstract:

Objectives

To investigate the fat content and microcirculation in the steroid-induced osteonecrosis of the femoral head (SIONFH) and their relationship with the development of SIONFH by multimodal magnetic resonance imaging.

Methods

SIONFH patients in pre-collapse stage (ARCO I to early ARCO Ⅲ stage) diagnosed in the First Affiliated Hospital of Guangzhou University of Chinese Medicine were involved in our research. Multimodal magnetic resonance imaging [including sequences as iterative decomposition of water andfat with echo asymmetry and least squares estimation(IDEAL-IQ)、intravoxel incoherent motion diffusion-weightedimaging(IVIM-DWI), T₁WI and T₂WI/fs] were taken to measure the values in the research. The specific procedure was as follow: sequence of IVIM-DWI and IDEAL-IQ were utilized in the evaluation of fat fraction (FF) and microcirculation (f) in necrosis area, penumbra area and normal area, according to location of primary lesion assessed by sequence of T₁WI and T₂WI/fs. The correlations among the fat content, microcirculation and ARCO stage were explored in order to investigate the relationship between these two pathological mechanisms. The data were processed with one-way analysis of variance, least significant difference t test, and Pearson correlation analysis.

Results

There were significant differences in fat content and microcirculation in different regions of SIONFH (P<0.05). In IDEAL-IQ, the FF value was highest in necrosis area and lowest in penumbra area. In IVIM-DWI, the f value was lowest in necrosis area, and then penumbra area, and highest in normal area. The FF value was negatively correlated with the F value (r=-0.37, P<0.05). In the early stage of ARCO Ⅲ, the FF value was highest while the f value was lowest (P<0.05), and the FF value was positively correlated with the ARCO staging (r=0.72, P<0.01), but not in that of f value.

Conclusion

Quantitative analysis of multimodal magnetic resonance imaging (IDEAL-IQ, IVIM-DWI, T₁WI and T₂WI/fs) showed that there was a correlation between the fat content and microcirculation in the pre-collapse stage of SIONFH and both the pathological mechanism developed with the progress of SIONFH.

Key words: Femur head necrosis, Magnetic Resonance Imaging, Adipose Tissue, Microcirculation

Xiaorui Han, Guoju Hong, Qiushi Wei, Fengxiang Pang, Peng Yang, Yuesheng Zheng, Yongwei Dong, Wei He, Wei He. Application of multimodal magnetic resonance imaging in the study of pathological mechanism of microcirculation and fat content in steroid-induced osteonecrosis of the femoral head[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2020, 15(02): 122-127.

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References 17

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参数	坏死区	硬化区	正常区	F值	P值
FF值	102.42±36.67	38.56±13.04	75.24±14.55	51.76	<0.05
f值	0.30±0.07	0.34±0.08	0.40±0.08	12.36	<0.05

参数	坏死区	硬化区	正常区	F值	P值
FF值	102.42±36.67	38.56±13.04	75.24±14.55	51.76	<0.05
f值	0.30±0.07	0.34±0.08	0.40±0.08	12.36	<0.05

分区	分区	FF值	f值
坏死区	硬化区	63.856±4.522	－0.040±0.020
坏死区	正常区	27.180±5.121	－0.097±0.011
硬化区	坏死区	－63.856±4.522	0.040±0.020
硬化区	正常区	－36.676±6.299	－0.057±0.023
正常区	坏死区	－27.180±5.121	0.097±0.011
正常区	硬化区	36.676±6.299	0.057±0.023
t₁	?	10.137	－2.046
P₁	?	<0.05	0.044
t₂	?	4.315	－4.968
P₂	?	<0.05	<0.05
t₃	?	－10.137	2.046
P₃	?	<0.05	0.044
t₄	?	5.822	－2.901
P₄	?	<0.05	0.005
t₅	?	－4.315	4.968
P₅	?	<0.05	<0.05
t₆	?	5.822	2.901
P₆	?	<0.05	0.005

分区	分区	FF值	f值
坏死区	硬化区	63.856±4.522	－0.040±0.020
坏死区	正常区	27.180±5.121	－0.097±0.011
硬化区	坏死区	－63.856±4.522	0.040±0.020
硬化区	正常区	－36.676±6.299	－0.057±0.023
正常区	坏死区	－27.180±5.121	0.097±0.011
正常区	硬化区	36.676±6.299	0.057±0.023
t₁	?	10.137	－2.046
P₁	?	<0.05	0.044
t₂	?	4.315	－4.968
P₂	?	<0.05	<0.05
t₃	?	－10.137	2.046
P₃	?	<0.05	0.044
t₄	?	5.822	－2.901
P₄	?	<0.05	0.005
t₅	?	－4.315	4.968
P₅	?	<0.05	<0.05
t₆	?	5.822	2.901
P₆	?	<0.05	0.005

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