Clinica Reumatologica, Università Politecnica delle Marche, Ospedale "C. Urbani", Via dei Colli 52, 60035 Jesi, Ancona, Italy.
Nat Rev Rheumatol. 2014 Oct;10(10):628-34. doi: 10.1038/nrrheum.2014.145. Epub 2014 Sep 9.
For decades, diagnostic imaging in rheumatology has used conventional radiography. Over the past 10 years, MRI and ultrasonography have clearly shown their potential in diagnostic imaging in rheumatology and their use is revolutionizing the management of chronic arthritis, revealing subclinical inflammation and predicting progression of joint damage. Although validation processes for these imaging modalities are still ongoing, several investigations have now established the positive correlation between subclinical synovitis and radiographic progression of joint damage. Despite the available evidence and the diagnostic potential, there remains a substantial proportion of rheumatologists for whom MRI and ultrasonography findings do not influence their clinical decision-making. This Perspectives will discuss the key issues related to diagnostic imaging in patients with chronic arthritis, outlining how new imaging techniques have evolved over the past two decades and presenting the most attractive technological advances in this field.
几十年来，风湿科的诊断成像一直使用传统的射线照相术。在过去的 10 年中，MRI 和超声检查已清楚地显示出它们在风湿学诊断成像中的潜力，它们的使用正在彻底改变慢性关节炎的治疗方法，揭示亚临床炎症并预测关节损伤的进展。尽管这些成像方式的验证过程仍在进行中，但已有多项研究证实了亚临床滑膜炎与关节损伤的放射学进展之间存在正相关关系。尽管有了这些证据和诊断潜力，但仍有相当一部分风湿病医生认为 MRI 和超声检查结果不会影响他们的临床决策。本观点将讨论与慢性关节炎患者的诊断成像相关的关键问题，概述过去二十年来新的成像技术如何发展，并介绍该领域最具吸引力的技术进步。
