Cimmino M A, Bountis C, Silvestri E, Garlaschi G, Accardo S
Unità Operativa di Reumatologia, DI.M.I. and Dipartimento di Medicina Sperimentale, Università di Genova, Italy.
Semin Arthritis Rheum. 2000 Dec;30(3):180-95. doi: 10.1053/sarh.2000.9204.
To evaluate the role of magnetic resonance imaging (MRI) in the diagnosis, staging, and follow-up of the rheumatoid wrist.
A Medline search was performed to identify all publications from the years 1985 to 1999 concerning MRI of the wrist in patients with rheumatoid arthritis (RA). Additional papers were retrieved by scanning the references to the Medline-listed articles. Details of the MRI technique, as well as clinical data, were analyzed and compared.
A total of 55 papers were identified. There were considerable variations in imaging sequence, section type, and slice thickness. Erosions and synovitis were the conditions that mostly profited from the adoption of MRI. Although the visualization of erosions was better detailed with MRI than with conventional radiography, erosions were only rarely related to clinical and laboratory parameters. Another advantage was that synovitis imaging, which can be enhanced by contrast agents, was amenable to quantitation. The extent of the synovial surface and the rate of contrast enhancement in a series of consecutive, rapidly acquired images were the most common measures.
MRI of the rheumatoid wrist is a useful technique to ascertain the criteria for diagnosis and progression of RA, and to monitor the effects of treatment. Implementation of a standardized protocol could further increase its value.
评估磁共振成像（MRI）在类风湿性腕关节诊断、分期及随访中的作用。
进行了一项Medline检索，以识别1985年至1999年间所有关于类风湿性关节炎（RA）患者腕关节MRI的出版物。通过浏览Medline列出文章的参考文献检索到了其他论文。对MRI技术细节以及临床数据进行了分析和比较。
共识别出55篇论文。在成像序列、切片类型和切片厚度方面存在相当大的差异。侵蚀和滑膜炎是采用MRI受益最大的情况。虽然MRI对侵蚀的可视化比传统放射照相更详细，但侵蚀与临床和实验室参数的相关性很小。另一个优点是滑膜炎成像可通过造影剂增强，并且适合进行定量分析。滑膜表面的范围以及一系列连续快速采集图像中的造影剂增强率是最常用的测量方法。
类风湿性腕关节的MRI是确定RA诊断和进展标准以及监测治疗效果的有用技术。实施标准化方案可进一步提高其价值。
