Miese F R, Ostendorf B, Wittsack H-J, Reichelt D C, Kröpil P, Lanzman R S, Mamisch T C, Zilkens C, Jellus V, Quentin M, Schneider M, Scherer A
Institut für Radiologie, Heinrich-Heine Universität, Moorenstrasse 5, Düsseldorf.
Rofo. 2010 Oct;182(10):873-8. doi: 10.1055/s-0029-1245596. Epub 2010 Aug 19.
To evaluate the feasibility of molecular cartilage MRI in finger joints.
Delayed Gd(DTPA)²-enhanced MRI of the cartilage (dGEMRIC) using a variable flip angle approach (VFA) was performed for the metacarpophalangeal (MCP) joints II and III in nine healthy volunteers and eighteen patients with rheumatoid arthritis (RA). The cartilage thickness was measured. Additionally, dGEMRIC was performed on proximal interphalangeal joints (PIP) in two patients with finger osteoarthritis (OA).
the dGEMRIC index of the four evaluated cartilage areas was significantly decreased in RA patients compared to healthy subjects. The dGEMRIC index of MCP II phalangeal cartilage was 389.6 ± 85.5 msec vs. 558.7 ± 74.4 msec in healthy subjects. The metacarpal MCP II cartilage dGEMRIC index was 357.3 msec ± 97.1 msec vs. 490.0 ± 86.6 msec. The dGEMRIC indices of MCP III were: phalangeal 436.2 ± 113.6 msec in RA, 558.8 ± 115.5 msec in healthy subjects and metacarpal 398.0 ± 97.6 msec in RA and 529.6 ± 111.0 msec in healthy subjects. Age and cartilage thickness were not significantly different. In PIP joints of finger osteoarthritis patients, low dGEMRIC indices were noted, compared to the controls.
The dGEMRIC of finger joints is feasible in patients with RA and finger OA. Morphologically normal cartilage shows significantly decreased dGEMRIC values in RA, pointing towards cartilage degeneration on a molecular level. Further studies are needed to establish the usefulness of this technique for early diagnosis, prognosis and therapy monitoring.
评估分子软骨磁共振成像（MRI）在手指关节中的可行性。
对9名健康志愿者和18名类风湿关节炎（RA）患者的第二和第三掌指关节（MCP）采用可变翻转角方法（VFA）进行延迟钆（DTPA）²增强MRI软骨成像（dGEMRIC）。测量软骨厚度。此外，对两名手指骨关节炎（OA）患者的近端指间关节（PIP）进行了dGEMRIC检查。
与健康受试者相比，RA患者中四个评估软骨区域的dGEMRIC指数显著降低。健康受试者中，MCP II指骨软骨的dGEMRIC指数为558.7±74.4毫秒，而RA患者为389.6±85.5毫秒。MCP II掌骨软骨的dGEMRIC指数为490.0±86.6毫秒，而RA患者为357.3毫秒±97.1毫秒。MCP III的dGEMRIC指数分别为：RA患者指骨436.2±113.6毫秒，健康受试者558.8±115.5毫秒；RA患者掌骨398.0±97.6毫秒，健康受试者529.6±111.0毫秒。年龄和软骨厚度无显著差异。与对照组相比，手指骨关节炎患者的PIP关节dGEMRIC指数较低。
dGEMRIC用于RA和手指OA患者的手指关节检查是可行的。形态学上正常的软骨在RA中dGEMRIC值显著降低，表明在分子水平上存在软骨退变。需要进一步研究以确定该技术在早期诊断、预后和治疗监测中的实用性。
