Celal Bayar University Hospital, Manisa, Turkey.
Rheumatol Int. 2013 Jul;33(7):1837-44. doi: 10.1007/s00296-012-2658-z. Epub 2013 Jan 18.
The purpose of this study was to compare the value of conventional magnetic resonance imaging (MRI) finding of rheumatoid arthritis (RA) and computer-aided dynamic MRI measurements in predicting the activity of disease. The activity of the disease in 40 RA patients was evaluated by the disease activity score in 28 joints (DAS28). The conventional MRI of the wrists of all patients were scored for bone edema, synovitis and erosions, according to the criteria of RA-MRI scoring system (RAMRIS) developed by Outcome measures in rheumatology clinical trials (OMERACT) MR Imaging Group. Synovitis was also quantified by dynamic postcontrast MRI imaging using color coded maximum slope of increase maps and measurements of early enhancement rate (EER) and relative enhancement (RE). Twenty-two (55 %) patients with a score higher than 5.1 constituted the high disease activity group, 18 (45 %) patients with a score of 5.1 or less constituted moderate disease activity group. The dynamic MRI-EER score was the most significant parameter to differentiate between the groups (p = 0.001). Among OMERACT scores, only bone edema [p = 0.020 for wrist and p = 0.037 for metacarpophalangeal joints (MCP)] had a significant difference between the two groups. Dynamic MRI RE score and OMERACT scores for erosions and synovitis for both the wrist and MCP joints did not differ significantly between the two groups. Computer-aided dynamic MRI is a reliable, noninvasive method of evaluating the RA patients, which correlates with the DAS28 scores, at a higher significance than the OMERACT-RAMRIS scores.
本研究旨在比较常规磁共振成像(MRI)对类风湿关节炎(RA)的发现和计算机辅助动态 MRI 测量在预测疾病活动中的价值。40 例 RA 患者的疾病活动通过 28 个关节疾病活动评分(DAS28)进行评估。根据关节炎临床试验结局测量(OMERACT)MRI 成像组制定的 RA-MRI 评分系统(RAMRIS)标准,对所有患者的腕关节进行骨水肿、滑膜炎和侵蚀的常规 MRI 评分。滑膜炎也通过动态对比后 MRI 成像进行量化,使用彩色编码最大斜率增加图和早期增强率(EER)和相对增强(RE)的测量。22 例(55%)评分高于 5.1 的患者构成高疾病活动组,18 例(45%)评分在 5.1 或以下的患者构成中度疾病活动组。动态 MRI-EER 评分是区分两组的最显著参数(p = 0.001)。在 OMERACT 评分中,只有骨水肿[腕关节(p = 0.020)和掌指关节(MCP)(p = 0.037)]在两组之间有显著差异。两组之间动态 MRI-RE 评分和 OMERACT 评分的侵蚀和滑膜炎在腕关节和 MCP 关节之间无显著差异。计算机辅助动态 MRI 是一种可靠、无创的评估 RA 患者的方法,与 DAS28 评分相关性更高,比 OMERACT-RAMRIS 评分更显著。