Böttcher Joachim, Pfeil Alexander, Rosholm Anders, Schäfer Max-Ludwig, Malich Ansgar, Petrovitch Alexander, Seidl Bettina, Lehmann Gabriele, Mentzel Hans-Joachim, Hein Gert, Wolf Gunter, Kaiser Werner A
Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany.
J Digit Imaging. 2006 Sep;19(3):279-88. doi: 10.1007/s10278-006-0263-y.
Our study evaluates digital x-ray radiogrammetry (DXR) and Radiogrammetry Kit (RK) as a new diagnostic method for the measurement of disease-related osteoporosis including quantification of joint space narrowing dependent on the severity of rheumatoid arthritis (RA).
A total of 172 unselected patients with RA underwent computerized measurements of bone mineral density (BMD) and metacarpal index (MCI) by DXR, as well as a semiautomated measurement of joint space distances at the metacarpal-phalangeal articulation (JSD-MCP 2-5), both were analyzed from plain radiographs of the nondominant hand.
Correlations between DXR-BMD and DXR-MCI vs. parameters of RK were all significant (0.34 < R < 0.61; p < 0.01). An expected negative association was observed between RK parameters and the different scoring methods (-0.27 < R < -0.59). The maximum relative decrease in BMD vs. MCI as measured by DXR between the highest and lowest RA severity group was -27.7% vs. -27.5% (p < 0.01) for the modified Larsen Score, whereas the minimal value of relative DXR-BMD and DXR-MCI reduction could be documented for the Sharp Erosion Score (-20.8% vs. -26.8%; p < 0.01). The relative reduction of mean JSD-MCP using RK significantly varied from -25.0% (Sharp Erosion Score) to -41.2% (modified Larsen Score). In addition, an excellent reproducibility of DXR and RK could be verified.
DXR in combination with RK could be a promising, widely available diagnostic tool to supplement the different scoring methods of RA with quantitative data, allowing an earlier and improved diagnosis and more precision in determining disease progression.
我们的研究评估数字X线摄影测量法（DXR）和放射测量套件（RK）作为一种新的诊断方法，用于测量与疾病相关的骨质疏松症，包括根据类风湿性关节炎（RA）的严重程度对关节间隙变窄进行量化。
共有172例未经选择的RA患者通过DXR进行了骨密度（BMD）和掌骨指数（MCI）的计算机测量，以及在掌指关节处进行关节间隙距离（JSD-MCP 2-5）的半自动测量，两者均从非优势手的平片进行分析。
DXR-BMD和DXR-MCI与RK参数之间的相关性均显著（0.34 < R < 0.61；p < 0.01）。在RK参数与不同评分方法之间观察到预期的负相关（-0.27 < R < -0.59）。对于改良Larsen评分，最高和最低RA严重程度组之间通过DXR测量的BMD与MCI的最大相对下降分别为-27.7%和-27.5%（p < 0.01），而对于Sharp侵蚀评分，DXR-BMD和DXR-MCI相对下降的最小值可记录为-20.8%和-26.8%（p < 0.01）。使用RK时平均JSD-MCP的相对下降从-25.0%（Sharp侵蚀评分）到-41.2%（改良Larsen评分）有显著差异。此外，DXR和RK具有出色的可重复性。
DXR与RK相结合可能是一种有前景的、广泛可用的诊断工具，用定量数据补充RA的不同评分方法，从而实现更早、更准确的诊断，并在确定疾病进展方面更精确。
