Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Ann Rheum Dis. 2012 Mar;71(3):345-50. doi: 10.1136/annrheumdis-2011-200028. Epub 2011 Oct 11.
To examine the construct validity of MRI in the detection of structural hand osteoarthritis features with conventional radiography (CR) as reference and explore the association between radiographic severity and MRI-defined pathology.
106 hand osteoarthritis patients (97 women, mean age 68.9 years (SD 5.6)) had 1.0T contrast-enhanced MRI and CR of the dominant hand. The 2nd-5th interphalangeal joints were scored according to the preliminary Oslo hand osteoarthritis MRI score and Kellgren-Lawrence (KL) scale and Osteoarthritis Research Society International atlas for radiographs. The authors compared the number of joints with structural features by MRI and CR (Wilcoxon signed-rank test) and examined concordance at the individual joint level. The OR of MRI features in joints with doubtful (KL grade 1), mild (2) and moderate/severe (≥3) radiographic osteoarthritis was estimated by generalised estimating equations (KL grade 0 as reference).
MRI detected approximately twice as many joints with erosions and osteophytes compared with CR (p<0.001), but identification of joint space narrowing, cysts and malalignment was similar. The sensitivity of MRI was very high for osteophytes (1.00) and erosions (0.95), while specificity was lower (0.22 and 0.63). The prevalence of most MRI features increased with radiographic severity, but synovitis was more frequent in joints with mild osteoarthritis (OR2.1, 95% CI 1.4 to 3.2) than in moderate/severe osteoarthritis (OR1.4, 95% CI 1.0 to 2.2).
MRI detected more osteophytes and erosions than CR, suggesting that erosive osteoarthritis may be more common than indicated by CR. Synovitis was most common in mild osteoarthritis. Whether this is due to burn-out of inflammation in late disease must be investigated further.
以常规放射摄影（CR）为参照，研究 MRI 检测手部结构骨关节炎特征的结构效度，并探讨放射学严重程度与 MRI 定义的病理学之间的关联。
106 例手部骨关节炎患者（97 名女性，平均年龄 68.9 岁（标准差 5.6））进行了 1.0T 对比增强 MRI 和手部 CR 检查。第 2-5 指间关节根据初步的奥斯陆手部骨关节炎 MRI 评分和 Kellgren-Lawrence（KL）量表以及国际骨关节炎研究协会放射学图谱进行评分。作者比较了 MRI 和 CR 检测到的结构特征关节数量（Wilcoxon 符号秩检验），并在个体关节水平上检查了一致性。使用广义估计方程（KL 分级 0 作为参照）估计了 MRI 特征在可疑（KL 分级 1）、轻度（2）和中度/重度（≥3）放射学骨关节炎关节中的比值比（OR）。
与 CR 相比，MRI 检测到的侵蚀和骨赘关节数约多出一倍（p<0.001），但关节间隙狭窄、囊肿和错位的识别相似。MRI 对骨赘（1.00）和侵蚀（0.95）的敏感性非常高，而特异性较低（0.22 和 0.63）。大多数 MRI 特征的患病率随着放射学严重程度的增加而增加，但在轻度骨关节炎关节中，滑膜炎更为常见（OR2.1，95%CI 1.4 至 3.2），而在中度/重度骨关节炎关节中则不常见（OR1.4，95%CI 1.0 至 2.2）。
与 CR 相比，MRI 检测到的骨赘和侵蚀更多，这表明侵蚀性骨关节炎可能比 CR 所显示的更为常见。滑膜炎在轻度骨关节炎中最为常见。这是否是由于晚期疾病中炎症的枯竭，还需要进一步研究。
