Freeston Jane E, Bird Paul, Conaghan Philip G
Chapel Allerton Hospital, University of Leeds, UK.
Curr Opin Rheumatol. 2009 Mar;21(2):95-101. doi: 10.1097/BOR.0b013e32832498f0.
This review describes the important role of MRI in rheumatoid arthritis (RA), exploring recent reliability and validity work, as well as the current use of MRI in clinical trials and practice.
Both bone oedema and erosions on MRI have been confirmed as representing osteitis and cortical bone defects, respectively, adding to what was already known about the validity of contrast enhanced synovium representing synovitis. An increasing number of studies have used MRI as an outcome measure with interest moving from disease-modifying antirheumatic drugs (DMARDs) to biological therapies and a more technical focus on dynamic imaging. In addition, low-field extremity MRI has been developed as a well tolerated, comfortable and convenient method for imaging assessment in clinical practice.
This review has highlighted both recent research advances as well as the future potential for MRI in RA, with the aim that MRI will become part of standard measures for RA clinical trials. With respect to extremity imaging, further work is required to provide useful clinical algorithms.
本综述描述了MRI在类风湿关节炎(RA)中的重要作用,探讨了近期的可靠性和有效性研究,以及MRI在临床试验和实践中的当前应用情况。
MRI上的骨水肿和侵蚀分别被证实代表骨炎和皮质骨缺损,这进一步补充了关于对比增强滑膜代表滑膜炎的有效性的已知信息。越来越多的研究将MRI用作结局指标,研究兴趣已从改善病情抗风湿药(DMARDs)转向生物疗法,并且在技术上更侧重于动态成像。此外,低场四肢MRI已发展成为一种在临床实践中耐受性良好、舒适且便捷的成像评估方法。
本综述强调了MRI在RA方面的近期研究进展以及未来潜力,目标是使MRI成为RA临床试验标准测量方法的一部分。关于四肢成像,还需要进一步开展工作以提供有用的临床算法。