MRI 生物标志物在骨关节炎中的并发和预测有效性的系统评价。
Systematic review of the concurrent and predictive validity of MRI biomarkers in OA.
机构信息
Rheumatology Department, Royal North Shore Hospital and Northern Clinical School, University of Sydney, Sydney, NSW, Australia.
出版信息
Osteoarthritis Cartilage. 2011 May;19(5):557-88. doi: 10.1016/j.joca.2010.10.029. Epub 2011 Mar 23.
OBJECTIVE
To summarize literature on the concurrent and predictive validity of MRI-based measures of osteoarthritis (OA) structural change.
METHODS
An online literature search was conducted of the OVID, EMBASE, CINAHL, PsychInfo and Cochrane databases of articles published up to the time of the search, April 2009. 1338 abstracts obtained with this search were preliminarily screened for relevance by two reviewers. Of these, 243 were selected for data extraction for this analysis on validity as well as separate reviews on discriminate validity and diagnostic performance. Of these 142 manuscripts included data pertinent to concurrent validity and 61 manuscripts for the predictive validity review. For this analysis we extracted data on criterion (concurrent and predictive) validity from both longitudinal and cross-sectional studies for all synovial joint tissues as it relates to MRI measurement in OA.
RESULTS
Concurrent validity of MRI in OA has been examined compared to symptoms, radiography, histology/pathology, arthroscopy, CT, and alignment. The relation of bone marrow lesions, synovitis and effusion to pain was moderate to strong. There was a weak or no relation of cartilage morphology or meniscal tears to pain. The relation of cartilage morphology to radiographic OA and radiographic joint space was inconsistent. There was a higher frequency of meniscal tears, synovitis and other features in persons with radiographic OA. The relation of cartilage to other constructs including histology and arthroscopy was stronger. Predictive validity of MRI in OA has been examined for ability to predict total knee replacement (TKR), change in symptoms, radiographic progression as well as MRI progression. Quantitative cartilage volume change and presence of cartilage defects or bone marrow lesions are potential predictors of TKR.
CONCLUSION
MRI has inherent strengths and unique advantages in its ability to visualize multiple individual tissue pathologies relating to pain and also predict clinical outcome. The complex disease of OA which involves an array of tissue abnormalities is best imaged using this imaging tool.
目的
总结基于磁共振成像（MRI）的骨关节炎（OA）结构变化的同时性和预测性有效性的文献。
方法
对 OVID、EMBASE、CINAHL、PsychInfo 和 Cochrane 数据库进行在线文献检索，检索时间截至 2009 年 4 月。对该检索获得的 1338 篇摘要进行初步筛选，以确定其相关性，由两位评审员进行筛选。其中，243 篇被选为此次分析的有效性，以及单独的鉴别有效性和诊断性能的回顾。在这 142 篇论文中，有 142 篇包含了与同步有效性相关的数据，61 篇包含了预测有效性审查的数据。在这项分析中，我们从所有关节组织的纵向和横断面研究中提取了与 OA 中 MRI 测量相关的标准（同时性和预测性）有效性数据。
结果
与症状、放射摄影、组织病理学/病理学、关节镜、CT 和对准相关，对 OA 中的 MRI 进行了同时性有效性检查。骨髓病变、滑膜炎和积液与疼痛之间存在中度至强相关性。软骨形态或半月板撕裂与疼痛之间的关系较弱或不存在。软骨形态与放射学 OA 和放射学关节间隙之间的关系不一致。在有放射学 OA 的人群中，半月板撕裂、滑膜炎和其他特征的发生率较高。软骨与其他结构（包括组织学和关节镜）之间的关系更强。OA 中的 MRI 预测性有效性已针对其预测全膝关节置换（TKR）、症状变化、放射学进展以及 MRI 进展的能力进行了检查。定量软骨体积变化以及软骨缺损或骨髓病变的存在是 TKR 的潜在预测因素。
结论
MRI 在其可视化与疼痛相关的多种个体组织病理学以及预测临床结果的能力方面具有固有优势和独特优势。涉及一系列组织异常的 OA 这种复杂疾病最好使用这种成像工具进行成像。
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