Cimmino Marco Amedeo, Barbieri Francesca, Boesen Mikael, Paparo Francesco, Parodi Massimiliano, Kubassova Olga, Scarpa Raffaele, Zampogna Giuseppe
Clinica Reumatologica, Dipartimento di Medicina Interna e Specialità Mediche, University of Genoa, Genova, Italy.
J Rheumatol Suppl. 2012 Jul;89:44-8. doi: 10.3899/jrheum.120242.
Dynamic, contrast-enhanced magnetic resonance imaging (DCE-MRI), the quantification of enhancement within the synovial membrane and bone by extracting curves using fast T1-weighted sequences during intravenous administration of contrast agent, evaluates synovitis and bone marrow edema in psoriatic arthritis (PsA). In this pilot study, we looked at possible differences between joint synovitis and tenosynovitis in PsA as compared with rheumatoid arthritis (RA).
Seven patients with PsA and 10 with RA were studied. After DCE-MRI was performed on 3 axial slices of the wrist, the enhancement ratio was calculated on 6 different regions of interest (ROI) of the synovial membrane outlined by the operator: the wrist compartment, 3 extensor tendon compartments, and 2 flexor compartments. DCE-MRI results were quantitatively analyzed using the Dynamika software, a computer-aided semiautomated method.
In PsA, the area of the ROI outlined around the first and second extensor compartments was larger than in RA; the opposite was true for the extensor carpi ulnaris region. The volume of inflammation was significantly higher in RA than in PsA for all the extensor compartments except the second, and in the joint synovial membrane. The DCE-MRI indicators of the degree of inflammation were higher for PsA in the joint synovial membrane (p = 0.002 and p < 0.001, respectively). There was a significant correlation between volume of inflammation but not its degree and 28-joint Disease Activity Score at the level of the wrist joint (r = 0.6; p = 0.01).
DCE-MRI can reveal useful and potentially clinically important information on the characteristics of different types of arthritis.
动态对比增强磁共振成像（DCE-MRI）通过在静脉注射造影剂期间使用快速T1加权序列提取曲线来量化滑膜和骨骼内的强化情况，可评估银屑病关节炎（PsA）中的滑膜炎和骨髓水肿。在这项初步研究中，我们观察了PsA与类风湿关节炎（RA）相比，关节滑膜炎和腱鞘炎之间可能存在的差异。
对7例PsA患者和10例RA患者进行了研究。在对腕部的3个轴向切片进行DCE-MRI检查后，计算由操作者勾勒出的滑膜6个不同感兴趣区域（ROI）的强化率：腕部区域、3个伸肌腱区域和2个屈肌区域。使用Dynamika软件（一种计算机辅助半自动方法）对DCE-MRI结果进行定量分析。
在PsA中，第一和第二伸肌区域周围勾勒出的ROI面积大于RA；尺侧腕伸肌区域则相反。除第二个伸肌区域外，所有伸肌区域以及关节滑膜中，RA的炎症体积均显著高于PsA。PsA关节滑膜的炎症程度DCE-MRI指标更高（分别为p = 0.002和p < 0.001）。在腕关节水平，炎症体积与其程度之间存在显著相关性，但炎症程度与28关节疾病活动评分之间无显著相关性（r = 0.6；p = 0.01）。
DCE-MRI可以揭示不同类型关节炎特征的有用且可能具有临床重要性的信息。
