Bley T A, Markl M, Schelp M, Uhl M, Frydrychowicz A, Vaith P, Peter H-H, Langer M, Warnatz K
Department of Diagnostic Radiology and Medical Physics, University Hospital Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
Rheumatology (Oxford). 2008 Jan;47(1):65-7. doi: 10.1093/rheumatology/kem283.
To determine the effect of corticosteroid treatment on mural inflammatory hyperenhancement in MRI in GCA.
MRI of the superficial temporal artery with sub-millimetre in-plane spatial resolution (195 x 260 microm) was performed in 17 patients with proven GCA at the initiation of corticosteroid treatment and after 16 months of therapy. Visual MRI scores for mural inflammation were correlated with clinical and laboratory findings.
Intensity of inflammatory hyperenhancement decreased significantly under corticosteroid therapy (2.3 +/- 0.6 vs 0.5 +/- 0.6, P < 0.001, with MRI score >2 indicating vasculitis). This finding correlated with the clinical and serological remission in 15/17 patients. Of the two patients with active disease, one had persisting mural inflammation in MRI indicative of relapsing disease. The other patient presenting with signs of polymyalgia rheumatica had no inflammatory changes of the superficial temporal arteries on MRI scan at follow-up.
Mural contrast enhancement in high-resolution MRI is pronounced in active disease and decreases under corticosteroid treatment, correlating well with laboratory remission.
确定皮质类固醇治疗对巨细胞动脉炎（GCA）患者MRI中血管壁炎性强化的影响。
对17例经证实的GCA患者在开始皮质类固醇治疗时及治疗16个月后进行颞浅动脉的MRI检查，其平面内空间分辨率达亚毫米级（195×260微米）。将血管壁炎症的MRI视觉评分与临床及实验室检查结果进行关联分析。
在皮质类固醇治疗下，炎性强化强度显著降低（分别为2.3±0.6和0.5±0.6，P<0.001，MRI评分>2表明存在血管炎）。这一发现与15/17例患者的临床及血清学缓解相关。在两名疾病活动的患者中，一名患者MRI显示血管壁炎症持续存在，提示疾病复发。另一名表现为风湿性多肌痛体征的患者在随访时MRI扫描显示颞浅动脉无炎性改变。
在活动性疾病中，高分辨率MRI显示的血管壁对比增强明显，在皮质类固醇治疗下降低，与实验室缓解情况密切相关。
