手部类风湿关节炎：简化磁共振成像评分方法的监测——初步评估。
Rheumatoid arthritis of the hand: monitoring with a simplified MR imaging scoring method--preliminary assessment.
机构信息
Department of Medical Imaging and Rheumatology, Hôpital Lapeyronie, Montpellier Cedex 5, France.
出版信息
Radiology. 2010 Sep;256(3):863-9. doi: 10.1148/radiol.10091759. Epub 2010 Jul 27.
PURPOSE
To assess a simplified scoring method (Simplified Rheumatoid Arthritis Magnetic Resonance Imaging Score [SAMIS]) developed to shorten interpretation time, while retaining both correlation with Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) and same or better intra- and interreader reliability.
MATERIALS AND METHODS
Ethics board approval and written patient consent were obtained. The study was HIPAA compliant. Thirty-eight patients with rheumatoid arthritis and 20 patients with no or early unclassified arthritis underwent magnetic resonance imaging of both wrists and hands. RAMRIS was used to evaluate erosions (scale, 0-10), edema (scale, 0-3), and synovitis (scale, 0-3). SAMIS assessed only one hand and was based on the radiographic Simple Erosion Narrowing Score, thus reducing the number of study areas from 116 to 36. Erosions were scored with a scale from 1 to 10. Edema and synovitis were, respectively, scored with scales from 0 to 1 and 0 to 2. SAMIS correlation with RAMRIS was tested by using the Spearman test. Last, the intra- and interobserver reproducibility of both scores were calculated.
RESULTS
SAMIS was closely correlated with RAMRIS for the entire series (r = 0.91, 0.79, and 0.94, respectively, for erosion, edema, and synovitis), as well as in patients with rheumatoid arthritis (r = 0.93, 0.81, and 0.92) and those with no or unclassified arthritis (r = 0.83, 0.73, and 0.94). The time needed to assess examination results with RAMRIS ranged from 5 to 20 minutes (13 minutes +/- 3.90 [standard deviation]), whereas it ranged from 2 to 7 minutes (5 minutes +/- 1.45) with SAMIS. For each of the three features (erosion, edema, and synovitis), intraobserver agreement (RAMRIS: kappa = 0.67, 0.94, 0.81, respectively; SAMIS: kappa = 0.66, 1.0, 0.91) and interobserver agreement (RAMRIS: kappa = 0.61, 0.58, 0.74, respectively; SAMIS: kappa = 0.59, 0.81, 0.81) were good to excellent.
CONCLUSION
This simplified reproducible scoring scheme could be used to monitor joint damage in rheumatoid arthritis. (c) RSNA, 2010.
目的
评估一种简化的评分方法（简化的类风湿关节炎磁共振成像评分[SAMIS]），该方法旨在缩短解释时间，同时保留与类风湿关节炎磁共振成像评分（RAMRIS）的相关性，并具有相同或更好的内部和观察者间可靠性。
材料和方法
获得伦理委员会批准和患者书面同意。本研究符合 HIPAA 规定。38 例类风湿关节炎患者和 20 例无或早期未分类关节炎患者接受了手腕和手部的磁共振成像检查。RAMRIS 用于评估侵蚀（评分范围为 0-10）、水肿（评分范围为 0-3）和滑膜炎（评分范围为 0-3）。SAMIS 仅评估一只手，基于放射学简单侵蚀狭窄评分，因此研究区域数量从 116 个减少到 36 个。侵蚀评分范围为 1-10。水肿和滑膜炎分别以 0-1 和 0-2 的评分量表进行评分。SAMIS 与 RAMRIS 的相关性通过 Spearman 检验进行测试。最后，计算了两种评分的观察者内和观察者间可重复性。
结果
SAMIS 与整个系列的 RAMRIS 密切相关（侵蚀、水肿和滑膜炎的相关系数分别为 0.91、0.79 和 0.94），以及类风湿关节炎患者（相关系数为 0.93、0.81 和 0.92）和无或未分类关节炎患者（相关系数为 0.83、0.73 和 0.94）。使用 RAMRIS 评估检查结果的时间范围为 5 至 20 分钟（平均 13 分钟 +/- 3.90[标准差]），而使用 SAMIS 的时间范围为 2 至 7 分钟（平均 5 分钟 +/- 1.45）。对于三种特征（侵蚀、水肿和滑膜炎）中的每一种，观察者内一致性（RAMRIS：kappa = 0.67、0.94、0.81，分别；SAMIS：kappa = 0.66、1.0、0.91）和观察者间一致性（RAMRIS：kappa = 0.61、0.58、0.74，分别；SAMIS：kappa = 0.59、0.81、0.81）均为良好至极好。
结论
这种简化的可重复评分方案可用于监测类风湿关节炎的关节损伤。（c）RSNA，2010。
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