Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal.
Skeletal Radiol. 2012 Jan;41(1):51-9. doi: 10.1007/s00256-011-1112-8. Epub 2011 Feb 12.
To determine whether measurement of synovial enhancement and thickness quantification parameters with 3.0-Tesla magnetic resonance imaging (3-T MRI) can reliably quantify disease activity in patients with early polyarthritis.
Eighteen patients (16 women, 2 men; mean age 46 years) with early polyarthritis with less than 12 months of symptoms were included. MRI examination using 3-T device was performed by a new approach including both wrists and hands simultaneously in the examination field-of-view. MRI scoring of disease activity included quantification of synovial enhancement with simple measurements such as rate of early enhancement (REE; REE(57) = S(57)/S(200), where S(57) and S(200) are the signal intensities 57 s and 200 s after gadolinium injection) and rate of relative enhancement (RE; RE = S(200) - S(0)). Both wrists and hands were scored according to the Rheumatoid Arthritis MRI Scoring System (RAMRIS) for synovitis. Disease activity was clinically assessed by the 28-joint Disease Activity Score (DAS28).
DAS28 score was strongly correlated with RE (r = 0.8331, p < 0.0001), REE (r = 0.8112, p < 0.0001), and RAMRIS score for synovitis (r = 0.7659, p < 0.0002). An REE score above 0.778 accurately identified patients with clinically active disease (sensitivity 92%; specificity 67%; p < 0.05). A statistically significant difference was observed in the RE, REE, and RAMRIS scores for synovitis between patients with active and inactive disease (p < 0.05).
Our findings support the use of 3-T dynamic contrast-enhanced MRI for precise quantification of disease activity and for discriminating active disease from inactive disease in early polyarthritis.
确定使用 3.0 特斯拉磁共振成像（3-T MRI）测量滑膜增强和厚度定量参数是否能可靠地量化早期多关节炎患者的疾病活动度。
纳入 18 例（16 名女性，2 名男性；平均年龄 46 岁）症状少于 12 个月的早期多关节炎患者。使用 3-T 设备进行 MRI 检查，通过一种新方法同时检查包括双手腕在内的检查视野。疾病活动度的 MRI 评分包括通过简单测量来量化滑膜增强，例如早期增强率（REE；REE(57)=S(57)/S(200)，其中 S(57)和 S(200)是钆注射后 57s 和 200s 的信号强度）和相对增强率（RE；RE=S(200)-S(0)）。根据类风湿关节炎 MRI 评分系统（RAMRIS）对腕关节和手关节进行滑膜炎评分。通过 28 关节疾病活动评分（DAS28）进行临床疾病活动评估。
DAS28 评分与 RE（r=0.8331，p<0.0001）、REE（r=0.8112，p<0.0001）和滑膜炎的 RAMRIS 评分（r=0.7659，p<0.0002）均呈强相关性。REE 评分高于 0.778 可准确识别出临床活动性疾病患者（敏感性 92%，特异性 67%，p<0.05）。在滑膜炎的 RE、REE 和 RAMRIS 评分方面，活动期和非活动期患者之间存在统计学显著差异（p<0.05）。
我们的研究结果支持使用 3-T 动态对比增强 MRI 对早期多关节炎疾病活动度进行精确量化，并区分活动性疾病和非活动性疾病。
