RESUMO
OBJECTIVE: To evaluate the association of prevalent unilateral total hip arthroplasty (THA) with worsening of degenerative knee abnormalities and clinical outcomes in the ipsilateral and contralateral knee. METHODS: Both knees of 30 individuals in the Osteoarthritis Initiative (OAI) with unilateral THA (n = 14 left, n = 16 right) at baseline were assessed at baseline and at 4-year follow-up for Whole-organ MR Imaging Scores (WORMS), cartilage T2 relaxation times (only available for right knees), Western Ontario and McMasters Universities Arthritis Index (WOMAC) scores and upper leg isometric strength. Right knees of 30 individuals without THA were analyzed as controls. Contralateral knees were compared to ipsilateral knees with paired t-tests and to control knees with multivariate regression analysis adjusting for covariates. RESULTS: In paired analyses, compared to ipsilateral knees, contralateral knees had higher WORMS total (P = 0.008) and cartilage scores (P = 0.007) at baseline. Over 4 years contralateral knees worsened more on WORMS total score (P = 0.008). Cartilage T2 values were higher in knees contralateral to the THA (baseline, P = 0.02; follow-up, P < 0.001). Contralateral knees had greater declines in knee extension strength (P = 0.04) and had a trend for greater worsening in WOMAC pain, stiffness, function and total scores (P = 0.04-0.09). Similar results were found comparing contralateral knees with control knees in multivariate regression models. CONCLUSIONS: Prevalent unilateral THA is associated with an greater progression of degenerative findings for the knee contralateral to THA.
Assuntos
Artroplastia de Quadril/efeitos adversos , Osteoartrite do Joelho/etiologia , Idoso , Estudos de Casos e Controles , Progressão da Doença , Feminino , Humanos , Contração Isométrica/fisiologia , Articulação do Joelho/fisiopatologia , Estudos Longitudinais , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/fisiopatologia , Índice de Gravidade de DoençaRESUMO
OBJECTIVE: To determine whether knee cartilage composition differs between African-American and Caucasian-American women at risk for Osteoarthritis (OA) using in vivo 3 T MRI T2 relaxation time measurements. METHODS: Right knee MRI studies of 200 subjects (100 African-American women, and 100 closely matched Caucasian-American women) were selected from the Osteoarthritis Initiative (OAI). Knee cartilage was segmented in the patellar (PAT), medial and lateral femoral (MF/LF), and medial and lateral tibial compartments (MT/LT)). Mean T2 relaxation time values per compartment and per whole joint cartilage were generated and analyzed spatially via laminar and grey-level co-occurrence matrix (GLCM) texture methods. Presence and severity of cartilage lesions per compartment were graded using a modified WORMS grading. Statistical analysis employed paired t- and McNemar testing. RESULTS: While African-American women and Caucasian-Americans had similar WORMS cartilage lesion scores (P = 0.970), African-Americans showed significantly lower mean T2 values (â¼1 ms difference; â¼0.5SD) than Caucasian-Americans in the whole knee cartilage (P < 0.001), and in the subcompartments (LF: P = 0.001, MF: P < 0.001, LT: P = 0.019, MT: P = 0.001) and particularly in the superficial cartilage layer (whole cartilage: P < 0.001, LF: P < 0.001, MF: P < 0.001, LT: P = 0.003, MT: P < 0.001). T2 texture parameters were also significantly lower in the whole joint cartilage of African-Americans than in Caucasian-Americans (variance: P = 0.001; contrast: P = 0.018). In analyses limited to matched pairs with no cartilage lesions in a given compartment, T2 values remained significantly lower in African-Americans. CONCLUSION: Using T2 relaxation time as a biomarker for the cartilage collagen network, our findings suggest racial differences in the biochemical knee cartilage composition between African-American and Caucasian-American women.
Assuntos
Cartilagem Articular/química , Articulação do Joelho , Negro ou Afro-Americano , Idoso , Cartilagem Articular/diagnóstico por imagem , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Radiografia , Estados Unidos , População BrancaRESUMO
Magnetic resonance imaging (MRI) T(2) relaxation time assesses non-invasively cartilage composition and can be used as early biomarker for knee osteoarthritis. Most knee cartilage segmentation techniques were primarily developed for volume measurements in DESS or SPGR sequences. For T(2) quantifications, these segmentations need to be superimposed on T(2) maps. However, given that these procedures are time consuming and require manual alignment, using them for analysis of T(2) maps in large clinical trials like the Osteoarthritis Initiative (OAI) is challenging. A novel direct segmentation technique (DST) for T(2) maps was therefore developed. Using the DST, T(2) measurements were performed and compared with those determined with an established segmentation superimposition technique (SST). MR images of five OAI participants were analysed with both techniques three times by one reader and five different images sets additionally with DST three times by two readers. Segmentations and T(2) measurements of one knee required on average 63±3min with DST (vs 302±13min for volume and T(2) measurements with SST). Bland-Altman plots indicated good agreement between the two segmentation techniques, respectively the two readers. Reproducibility errors of both techniques (DST vs SST) were similar (P>0.05) for whole knee cartilage mean T(2) (1.46% vs 2.18%), laminar (up to 2.53% vs 3.19%) and texture analysis (up to 8.34% vs 9.45%). Inter-reader reproducibility errors of DST were higher for texture analysis (up to 15.59%) than for mean T(2) (1.57%) and laminar analysis (up to 2.17%). Due to these results, the novel DST can be recommended for T(2) measurements in large clinical trials like the OAI.
Assuntos
Cartilagem Articular/patologia , Interpretação de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Articulação do Joelho/patologia , Imageamento por Ressonância Magnética/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos TestesRESUMO
We present a spectrometer for inverse photoemission in the vacuum ultraviolet range with variable energy resolution between 400 and 165 meV full width at half maximum. The energy distribution of the electron beam used for excitation can be adjusted between 300 and 125 meV by the use of a toroidal 90 degrees electrostatic deflector combined with a slit aperture. The emitted photons are detected by Geiger-Muller counters filled with either acetone or iodine as counting gas. The optical bandpasses of the detectors can be tuned between 100 and 330 meV by varying the temperature of their entrance windows. The overall resolution of the spectrometer is determined by measuring the Fermi-level onset in inverse-photoemission data of polycrystalline gold. Furthermore, the resolution enhancement is demonstrated by spectra of image-potential-induced surface states at Cu(001).
Assuntos
Espectrofotometria Ultravioleta/instrumentação , Desenho Assistido por Computador , Transferência de Energia , Desenho de Equipamento , Análise de Falha de Equipamento , Fótons , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Espectrofotometria Ultravioleta/métodosRESUMO
Osteoporosis is classified as a public health problem due to its increased risk for fragility fractures. Osteoporotic fractures, in particular spine and hip fractures, are associated with a high morbidity and mortality, and generate immense financial cost. The World Health Organisation (WHO) based the diagnosis of osteoporosis on the measurement of bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA). However, BMD values of subjects with versus without osteoporotic fractures overlap. Furthermore, it was reported that the anti-fracture effects of drugs could be only partially explained by their effects on BMD. Bone strength reflects the integration of BMD and bone quality. The later can be partly determined by measurements of bone microstructure. Therefore, substantial research efforts have been undertaken to assess bone microstructure by using high-resolution imaging techniques, including high-resolution peripheral quantitative computed tomography (hr-pQCT), high-resolution multi-detector computed tomography (MDCT), and high-resolution magnetic resonance imaging (MRI). Clinical MDCT and MRI systems are broadly available and allow an adequate depiction of the bone microstructure at the clinically most important fracture sites, i.e. radius, spine and hip. Bone microstructure parameters and finite element models can be computed in high-resolution MDCT and MR images. These measurements improved the prediction of bone strength beyond the DXA-derived BMD and revealed pharmacotherapy effects, which are partly not captured by BMD. Therefore, high-resolution bone imaging using clinical MDCT and MRI may be beneficial for osteoporosis diagnostics and allow a highly sensitive monitoring of drug treatment, which plays an important role in the prevention of fragility fractures.