Tehranzadeh Jamshid, Ashikyan Oganes, Dascalos Jane
Department of Radiological Sciences, University of California, Irvine, Orange, CA 92868, USA.
Semin Musculoskelet Radiol. 2003 Jun;7(2):79-94. doi: 10.1055/s-2003-41342.
Magnetic resonance imaging (MRI) is the modality of choice in early diagnosis and management of rheumatoid arthritis (RA). The pathologic processes in RA involve synovitis, joint effusion, proliferation of fibrovascular connective tissue, and the formation of pannus. Other imaging techniques available for imaging of RA include ultrasound, scintigraphy, computed tomography, and plain radiography (PR). MRI provides high sensitivity in detecting inflammatory changes in the joints. Several studies report high intra- and interobserver reliability and low variation for MRI. MRI allows detection and, in some cases, quantification of synovial changes. Dynamic MRI is a new technique that utilizes rate of synovial enhancement in evaluation of inflammatory changes. MRI allows visualization of erosions in three orthogonal planes. MRI has been shown in many studies to have much greater sensitivity than PR in detecting erosions. Use of a contrast agent further increases the sensitivity in detecting erosions and differentiates and outlines synovial proliferation from fluid collection. Other manifestations of RA such as intraosseous cysts, tenosynovitis, bone marrow edema, and carpal tunnel syndrome can also be visualized on magnetic resonance images. Advances in MRI include contrast-enhancement, dynamic, and quantitative techniques. MRI assists in the early detection of RA, which allows earlier initiation of treatment with disease-modifying therapies.
磁共振成像（MRI）是类风湿性关节炎（RA）早期诊断和管理的首选方式。RA的病理过程包括滑膜炎、关节积液、纤维血管结缔组织增生以及血管翳的形成。可用于RA成像的其他影像学技术包括超声、闪烁扫描、计算机断层扫描和平片摄影（PR）。MRI在检测关节炎症变化方面具有高灵敏度。多项研究报告称，MRI在观察者内部和观察者之间具有高可靠性且变异性低。MRI能够检测滑膜变化，在某些情况下还能对其进行量化。动态MRI是一种利用滑膜强化速率评估炎症变化的新技术。MRI能够在三个相互垂直的平面上显示侵蚀。许多研究表明，MRI在检测侵蚀方面的灵敏度远高于PR。使用造影剂可进一步提高检测侵蚀的灵敏度，并区分滑膜增生与积液并勾勒出其轮廓。RA的其他表现，如骨内囊肿、腱鞘炎、骨髓水肿和腕管综合征，也可在磁共振图像上显示。MRI的进展包括增强造影、动态和定量技术。MRI有助于RA的早期检测，从而能够更早地开始使用改善病情的疗法进行治疗。
