Østergaard Mikkel, Duer Anne, Møller Uffe, Ejbjerg Bo
Department of Rheumatology, Copenhagen University Hospitals at Herlev and Hvidovre, Kettegaard alle 30, DK-2650 Hvidovre, Copenhagen, Denmark.
Best Pract Res Clin Rheumatol. 2004 Dec;18(6):861-79. doi: 10.1016/j.berh.2004.06.001.
The need for better methods than the conventional clinical, biochemical and radiographical examinations in the management of inflammatory joint diseases is evident, since these methods are not sensitive or specific to early pathologies and subtle changes. Magnetic resonance imaging (MRI) offers improved sensitivity to early inflammatory and destructive changes in peripheral joints in rheumatoid arthritis (RA) and, even though less well documented, in other inflammatory joint diseases. Good evidence is available that MRI bone erosions represent true bone abnormalities and are predictors of radiographical outcome in RA. Similarly, there is solid evidence for MRI synovitis representing true synovial inflammation and being of considerable practical, clinical and radiological significance in RA. Describing the encouraging current knowledge regarding MRI for diagnosis, monitoring and prognosis, this chapter discusses the potential for the use of MRI in the clinical management of patients with suspected and diagnosed inflammatory joint diseases, as well as research priorities and clinical situations where the use of MRI could be suggested.
在炎症性关节疾病的管理中，显然需要比传统临床、生化和影像学检查更好的方法，因为这些方法对早期病变和细微变化不敏感或缺乏特异性。磁共振成像（MRI）对类风湿关节炎（RA）外周关节的早期炎症和破坏性变化具有更高的敏感性，在其他炎症性关节疾病中，尽管相关记录较少，但也有类似情况。有充分证据表明，MRI显示的骨侵蚀代表真正的骨异常，并且是RA影像学结果的预测指标。同样，有确凿证据表明，MRI显示的滑膜炎代表真正的滑膜炎症，在RA中具有相当大的实际、临床和放射学意义。本章描述了目前关于MRI在诊断、监测和预后方面令人鼓舞的知识，讨论了在疑似和确诊的炎症性关节疾病患者的临床管理中使用MRI的潜力，以及使用MRI的研究重点和可建议使用MRI的临床情况。
