Feng Feng, Yu Wei, Meng Chun-ling, Jiang Ming
Department of Radiology, PUMC Hospital, CAMS, PUMC, Beijing 100730, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2002 Oct;24(5):505-9.
To compare MR imaging with radiographs in detection of the erosions of the wrists in patients with rheumatoid arthritis (RA).
In 50 wrists of 25 patients with RA, radiographs of AP projection and MR imaging examination were performed within 1 week. The MRI sequences were SE T1-weighted image, FSE T2-weighted image, and GE T2* weighted image in coronal plane. Gd-DTPA enhanced SE T1-weighted image with same parameters of pre-contrast administration SE T1WI was performed in 25 wrists, which showed prominent lesions in each 25 patients.
In 50 wrists of 25 patients with RA, bone erosions were found by MR images compared to radiographs in 46 versus 14 wrists, respectively. There were 170 sites of carpal erosions found by MR images, while radiographs found only 23 sites of carpal erosions. Among them triquetrum and lunate were the most frequently involved sites. Significant difference (P < 0.001) was statistically found between conventional radiography and MR imaging in detection of erosions of the wrists of RA. MR imaging also permitted demonstrating synovitis and joint effusion in the wrists. Gd-DTPA-enhanced images allowed distinguishing pannus changes from joint effusion.
MRI is superior to conventional radiography with respect to detection of bone erosion in wrists. For those whose conventional radiographs show suspected RA, MRI examination should be advised for the early diagnosis.
比较磁共振成像（MR成像）与X线片对类风湿关节炎（RA）患者腕关节侵蚀的检测能力。
对25例RA患者的50个腕关节在1周内进行正位X线片及MR成像检查。MRI序列包括冠状面的SE T1加权像、FSE T2加权像及GE T2*加权像。对其中25例显示明显病变的患者的25个腕关节进行Gd-DTPA增强SE T1加权像检查，增强扫描参数与平扫SE T1WI相同。
25例RA患者的50个腕关节中，MR图像发现骨侵蚀46个腕关节，X线片发现14个腕关节。MR图像发现腕骨侵蚀部位170处，X线片仅发现23处。其中三角骨和月骨是最常受累部位。在检测RA患者腕关节侵蚀方面，传统X线摄影与MR成像之间存在显著差异（P < 0.001）。MR成像还能够显示腕关节滑膜炎及关节积液。Gd-DTPA增强图像可区分血管翳改变与关节积液。
在检测腕关节骨侵蚀方面，MRI优于传统X线摄影。对于传统X线片显示疑似RA的患者，建议行MRI检查以早期诊断。
