Klarlund M, Ostergaard M, Lorenzen I
Department of Rheumatology, Danish Research Centre of Magnetic Resonance, Hvidovre Hospital, University of Copenhagen, Denmark.
Rheumatology (Oxford). 1999 Jan;38(1):66-72. doi: 10.1093/rheumatology/38.1.66.
To assess quantitatively, by magnetic resonance imaging (MRI), the synovial membrane volume in second to fifth metacarpophalangeal (MCP) joints in patients with rheumatoid arthritis and healthy controls, and to compare the synovial membrane volumes with a more easily obtained semi-quantitative score for hypertrophic synovial membrane.
MCP joints of the dominant hand of 37 patients and five controls were examined clinically and by MRI. Laboratory assessments were performed.
Median synovial membrane volumes were considerably larger in clinically active rheumatoid arthritis (RA) joints (e.g. 0.97 ml in the second MCP joint) than in clinically inactive joints (0.54 ml) and control joints (0.04 ml). Nevertheless, group distributions overlapped and marked volume differences were found within clinically uniform groups. The semi-quantitative score was highly correlated with the synovial volumes (Spearman rho = 0.79; P < 0.00001). Synovial membrane volumes were poorly related to the presence of rheumatoid factor and to laboratory markers of inflammation.
These findings suggest that synovial membrane volumes, as determined by MRI, in finger joints are related to clinical signs of synovitis, but also that the volumes may vary more than what can be accounted for by the clinical appearances. A semi-quantitative score may be sufficient for more routine purposes.
通过磁共振成像（MRI）定量评估类风湿关节炎患者和健康对照者第二至第五掌指（MCP）关节的滑膜体积，并将滑膜体积与更易获得的肥厚滑膜半定量评分进行比较。
对37例患者和5例对照者优势手的MCP关节进行临床检查和MRI检查。进行实验室评估。
临床活动期类风湿关节炎（RA）关节（如第二MCP关节为0.97 ml）的滑膜体积中位数明显大于临床非活动期关节（0.54 ml）和对照关节（0.04 ml）。然而，组间分布有重叠，且在临床特征一致的组内发现了明显的体积差异。半定量评分与滑膜体积高度相关（Spearman秩相关系数=0.79；P<0.00001）。滑膜体积与类风湿因子的存在及炎症实验室指标的相关性较差。
这些发现表明，MRI测定的手指关节滑膜体积与滑膜炎的临床体征相关，但体积变化可能比临床外观所显示的更大。半定量评分可能足以满足更常规的目的。
