Sharp J T, Gardner J C, Bennett E M
University of Washington School of Medicine, Seattle, USA.
Arthritis Rheum. 2000 Jun;43(6):1378-86. doi: 10.1002/1529-0131(200006)43:6<1378::AID-ANR23>3.0.CO;2-H.
This study was conducted 1) to determine the feasibility of using computer programs to measure radiographic joint space width and estimate erosion volume in the hands of patients with rheumatoid arthritis (RA), and 2) to compare the new computer-based methods with established scoring methods.
To measure the joint space width in the finger and wrist joints of RA patients, hand and wrist radiographic films were scanned using a tabletop scanner and analyzed with programs written using the "macro" capabilities of NIH Image software. Estimation of erosion volume was determined by utilizing gray-scale intensity to calibrate bone density units per mm3, which made possible comparisons between the erosions and noneroded, anatomically similar sites.
In 3 sets of duplicate measurements of joint space width on 79, 48, and 48 finger and wrist joints, the mean absolute deviation from the mean of the 2 measurements was 0.036 mm (SD 0.034), 0.032 mm (SD 0.049), and 0.021 mm (SD 0.016), respectively. Joint space measurements and scoring of joint space narrowing both demonstrated a difference between active treatment and placebo in an old trial set on gold therapy (P = 0.03 and P = 0.01, respectively). Two repeated measurements of bone density units in the bones of 3 different hands differed from the mean of the measurement by 2.29-4.04%. In 2 experiments, estimates of erosion volume showed a greater difference between gold therapy and placebo than did erosion scores in the trial set (P = 0.049 and P = 0.016 versus P = 0.27).
Computer-based methods for measuring finger and wrist joint spaces and estimating erosion volume in patients with RA agree with the results of radiographic scoring of erosions and joint space narrowing.
本研究旨在 1）确定使用计算机程序测量类风湿关节炎（RA）患者手部关节间隙宽度和估计侵蚀体积的可行性，以及 2）将新的基于计算机的方法与既定的评分方法进行比较。
为测量 RA 患者手指和腕关节的关节间隙宽度，使用桌面扫描仪对手部和腕部 X 光片进行扫描，并使用利用 NIH Image 软件“宏”功能编写的程序进行分析。通过利用灰度强度校准每立方毫米的骨密度单位来确定侵蚀体积的估计值，这使得能够比较侵蚀部位与未侵蚀的、解剖结构相似的部位。
在对 79 个、48 个和 48 个手指及腕关节的关节间隙宽度进行的 3 组重复测量中，两次测量平均值的平均绝对偏差分别为 0.036 毫米（标准差 0.034）、0.032 毫米（标准差 0.049）和 0.021 毫米（标准差 0.016）。在一项关于金疗法的旧试验组中，关节间隙测量和关节间隙变窄评分均显示积极治疗与安慰剂之间存在差异（分别为 P = 0.03 和 P = 0.01）。对 3 只不同手部骨骼的骨密度单位进行的两次重复测量与测量平均值的差异为 2.29 - 4.04%。在 2 项实验中，侵蚀体积估计值显示金疗法与安慰剂之间的差异比试验组中的侵蚀评分更大（分别为 P = 0.049 和 P = 0.016，而侵蚀评分为 P = 0.27）。
基于计算机的测量 RA 患者手指和腕关节间隙以及估计侵蚀体积的方法与侵蚀和关节间隙变窄的 X 光评分结果一致。
