早期炎症性关节炎患者的滑膜炎通过动态对比增强光学成像和磁共振成像的定量分析进行监测。

Synovitis in patients with early inflammatory arthritis monitored with quantitative analysis of dynamic contrast-enhanced optical imaging and MR imaging.

机构信息

From the Departments of Radiology (R.M., P.B.N., M.S., C.A., R.A.N., C.G., M.W., C.S., S.W., E.J.R.) and Rheumatology (K.T., P.M.), II. Medizinische Klinik, and Institute of Medical Statistics and Epidemiology, Klinikum rechts der Isar (B.H.), Technische Universität München, Ismaningerstr 22, 81675 Munich, Germany; and Department of Internal Medicine, University of Colorado, Denver, Colo (D.G.).

出版信息

Radiology. 2014 Jan;270(1):176-85. doi: 10.1148/radiol.13130039. Epub 2013 Oct 28.

DOI:10.1148/radiol.13130039

PMID:23901126

Abstract

PURPOSE

To evaluate quantitative perfusion measurements of dynamic indocyanine green (ICG)-enhanced optical imaging for monitoring synovitis in the hands of patients with inflammatory arthritis compared with dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging and clinical outcome.

MATERIALS AND METHODS

This study was approved by the ethics committee at the institution. Individual joints (n = 840) in the hands and wrists of 28 patients (14 women; mean age, 53.3 years) with inflammatory arthritis were examined at three different time points: before start of therapy and 12 and 24 weeks after start of therapy or therapy escalation. Treatment response was assessed by using clinical measures (simple disease activity index [SDAI]), ICG-enhanced optical imaging, and DCE MR imaging. Dynamic images were obtained for optical imaging and DCE MR imaging. The rate of early enhancement (REE) of the perfusion curves of each joint was calculated by using in-house developed software. Correlation coefficients were estimated to evaluate the associations of changes of imaging parameters and SDAI change.

RESULTS

Quantitative perfusion measurements with optical imaging and MR imaging correctly identified patients who responded (n = 18) and did not respond to therapy (n = 10), as determined by SDAI. The difference of REE after 24 weeks of treatment compared with baseline in responders was significantly reduced in optical imaging and MR imaging (optical imaging: mean, -21.5%; MR imaging: mean, -41.0%; P < .001 for both), while in nonresponders it was increased (optical imaging: mean, 10.8%; P = .075; MR imaging: mean, 8.7%; P = .03). The REE of optical imaging significantly correlated with MR imaging (ρ = 0.80; P < .001) and SDAI (ρ = 0.61; P < .001).

CONCLUSION

Quantitative analysis of contrast-enhanced optical imaging allows for potential therapeutic monitoring of synovitis in patients with inflammatory arthritis.

摘要

目的

评估动态吲哚菁绿（ICG）增强光学成像定量灌注测量在监测炎症性关节炎患者手部滑膜炎方面的作用，与动态对比增强（DCE）磁共振（MR）成像和临床结果进行比较。

材料和方法

本研究获得机构伦理委员会批准。28 名炎症性关节炎患者（14 名女性；平均年龄，53.3 岁）的手部和腕部共 840 个关节，在治疗开始前以及治疗开始后 12 周和 24 周进行 3 次检查。采用临床指标（简单疾病活动指数[SDAI]）、ICG 增强光学成像和 DCE MR 成像评估治疗反应。获取光学成像和 DCE MR 成像的动态图像。通过使用内部开发的软件计算每个关节灌注曲线的早期增强（REE）率。评估了成像参数变化与 SDAI 变化之间的相关性。

结果

通过光学成像和 MR 成像定量灌注测量，可以正确识别出 SDAI 确定的对治疗有反应（n = 18）和无反应（n = 10）的患者。在光学成像和 MR 成像中，治疗 24 周后与基线相比，反应者的 REE 明显降低（光学成像：平均，-21.5%；MR 成像：平均，-41.0%；两者均 P <.001），而无反应者则增加（光学成像：平均，10.8%；P =.075；MR 成像：平均，8.7%；P =.03）。光学成像的 REE 与 MR 成像（ρ=0.80；P <.001）和 SDAI（ρ=0.61；P <.001）显著相关。