Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Ann Rheum Dis. 2011 Jan;70(1):176-9. doi: 10.1136/ard.2009.126953. Epub 2010 Nov 10.
To examine the associations between modern imaging modalities and joint damage measured as 1-year MRI erosive progression, in early rheumatoid arthritis (RA) patients.
84 RA patients with disease duration of less than 1 year were included in this inception cohort. Patients were evaluated at baseline, 3, 6 and 12 months by core measures of disease activity, MRI and ultrasound grey-scale (USGS) of inflammation, conventional radiography and digital x-ray radiogrammetry (DXR) bone mineral density (BMD) of cortical hand bone.
53 of the 79 patients (67%) who completed the follow-up had MRI erosive progression (dependent variable). USGS and MRI bone marrow oedema (BME) were in multivariate analyses independent predictors of 1-year MRI erosive progression. There was a trend towards higher MRI synovitis score and 3-month DXR BMD loss in patients developing MRI erosions. On an individual level, USGS inflammation, MRI synovitis and MRI BME also somewhat better predicted outcome than rheumatoid factor, anticitrullinated protein antibodies and disease activity score 28.
USGS inflammation and MRI BME were independent predictors of MRI erosive progression in early RA patients on a group level. The exact prognosis of the individual patients could not be determined by imaging alone.
探讨在病程不足 1 年的早期类风湿关节炎（RA）患者中，现代影像学模式与关节损伤（以 1 年 MRI 侵蚀进展来衡量）之间的相关性。
本研究纳入了 84 例病程小于 1 年的 RA 患者。这些患者在基线、3 个月、6 个月和 12 个月时通过疾病活动的核心指标、MRI 和炎症的超声灰度（USGS）、常规放射摄影和数字 X 射线放射照相术（DXR）手部皮质骨骨密度（BMD）进行评估。
79 例完成随访的患者中有 53 例（67%）出现了 MRI 侵蚀进展（因变量）。在多变量分析中，USGS 和 MRI 骨髓水肿（BME）是 1 年 MRI 侵蚀进展的独立预测因子。在发生 MRI 侵蚀的患者中，MRI 滑膜炎评分和 3 个月 DXR BMD 丢失有升高的趋势。在个体水平上，USGS 炎症、MRI 滑膜炎和 MRI BME 也比类风湿因子、抗瓜氨酸蛋白抗体和 28 关节疾病活动评分（DAS28）更好地预测结局。
在病程不足 1 年的早期 RA 患者中，USGS 炎症和 MRI BME 是 MRI 侵蚀进展的独立预测因子。但仅凭影像学并不能确定个体患者的确切预后。
