原著
変形性膝関節症保存加療における膝蓋下脂肪体の体積変化
キーワード:
infrapatellar fat pad,
magnetic resonance,
osteoarthritis,
cartilage degeneration,
T1ρ mapping
2018 年 37 巻 2 号 p. 123-128
詳細
2018 年 37 巻 2 号 p. 123-128
Objective: The infrapatellar fat pad may be involved in the pathogenesis of osteoarthritis (OA) of the knee. This is as a result of release of adipokine and inflammatory cytokines by the aforementioned tissue. We evaluated articular cartilage in knees with OA using T1ρ mapping via magnetic resonance imaging (MRI) and clarified the relationship between cartilage degeneration and the volume of the infrapatellar fat pad.
Methods: Study subjects included 59 patients with knee arthralgia who were treated conservatively (19 men, 40 women, average age 57.2 years old, Kellgren-Lawrence classification grade 0: 13 cases, grade 1: 21 cases, grade 2: 18 cases, grade 3: 7 cases). MRI assessments were performed pre- and posttreatment (average observation period 7.9 months), and T1ρ values of the articular cartilage were calculated. Changes in the area of degenerated cartilage were measured by T1ρ mapping and categorized into three groups as follows: ‘improvement’, ‘no change’, and ‘deterioration’ groups, respectively. The volume change rate of the infrapatellar fat pads was determined using fat suppression T2-weighted imaging.
Results: Twenty-three subjects showed ‘improvement’, whereas 22 showed ‘no change’, and 14 showed ‘deterioration’, respectively. The volume change rate of the infrapatellar fat pads in the three groups were as follows: −5.3±6.1% in the ‘improvement’ group, −2.1±5.9% in the ‘no change’ group, and 0.25±7.1% in ‘deterioration’ group. A significant difference was observed among the three groups (P<0.05).
Conclusion: As the quality of articular cartilage improved, the infrapatellar fat pad volume decreased. The infrapatellar fat pad may be involved in the pathogenesis of degeneration of articular cartilage.
