OMERACT 类风湿关节炎磁共振成像（MRI）评分系统：OMERACT 关节炎工作组对 MRI 的更新建议。
The OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging (MRI) Scoring System: Updated Recommendations by the OMERACT MRI in Arthritis Working Group.
机构信息
From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen; Slagelse Hospital, Slagelse, Denmark; Spire Sciences Inc., Boca Raton, Florida; Medicine and Orthopedics, University of California; Synarc Inc., San Francisco, California, USA; University of New South Wales (NSW), Sydney, Australia; Hôpital Pitié-Salpétrière, APHP, Université Paris VI, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and UK National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK.
M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and the Department of Clinical Medicine, University of Copenhagen; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpital Pitié-Salpétrière, APHP, Université Paris VI; D. Glinatsi, MD, Research Fellow, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; E.A. Haavardsholm, MD, PhD, Professor, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, MPH, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; P. Bøyesen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; B. Ejbjerg, MD, PhD, Consultant Rheumatologist and Senior Lecturer, Slagelse Hospital, and Department of Clinical Medicine, University of Copenhagen; V. Foltz, MD, Practicing Rheumatologist, Hôpital Pitié-Salpétrière, APHP, Université Paris VI; P. Emery, MA, MD, FRCP, ARC Professor in Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre; H.K. Genant, MD, FACR, FRCR, Professor Emeritus of Radiology, Medicine and Orthopedics, University of California, San Francisco, and Synarc Inc.; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre.
出版信息
J Rheumatol. 2017 Nov;44(11):1706-1712. doi: 10.3899/jrheum.161433. Epub 2017 Aug 15.
OBJECTIVE
The Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis (RA) Magnetic Resonance Imaging (MRI) scoring system (RAMRIS), evaluating bone erosion, bone marrow edema/osteitis, and synovitis, was introduced in 2002, and is now the standard method of objectively quantifying inflammation and damage by MRI in RA trials. The objective of this paper was to identify subsequent advances and based on them, to provide updated recommendations for the RAMRIS.
METHODS
MRI studies relevant for RAMRIS and technical and scientific advances were analyzed by the OMERACT MRI in Arthritis Working Group, which used these data to provide updated considerations on image acquisition, RAMRIS definitions, and scoring systems for the original and new RA pathologies. Further, a research agenda was outlined.
RESULTS
Since 2002, longitudinal studies and clinical trials have documented RAMRIS variables to have face, construct, and criterion validity; high reliability and sensitivity to change; and the ability to discriminate between therapies. This has enabled RAMRIS to demonstrate inhibition of structural damage progression with fewer patients and shorter followup times than has been possible with conventional radiography. Technical improvements, including higher field strengths and improved pulse sequences, allow higher image resolution and contrast-to-noise ratio. These have facilitated development and validation of scoring methods of new pathologies: joint space narrowing and tenosynovitis. These have high reproducibility and moderate sensitivity to change, and can be added to RAMRIS. Combined scores of inflammation or joint damage may increase sensitivity to change and discriminative power. However, this requires further research.
CONCLUSION
Updated 2016 RAMRIS recommendations and a research agenda were developed.
目的
2002 年引入了关节影像学疗效评价（OMERACT）类风湿关节炎（RA）磁共振成像（MRI）评分系统（RAMRIS），用于评估骨侵蚀、骨髓水肿/炎和滑膜炎，目前已成为 RA 临床试验中客观定量评估 MRI 炎症和损伤的标准方法。本文的目的是确定随后的进展，并在此基础上为 RAMRIS 提供更新的建议。
方法
OMERACT MRI 在关节炎工作组对与 RAMRIS 相关的 MRI 研究和技术进展进行了分析，利用这些数据为原始和新的 RA 病理的图像采集、RAMRIS 定义和评分系统提供了更新的考虑因素。此外，还概述了一个研究议程。
结果
自 2002 年以来，纵向研究和临床试验已经证明了 RAMRIS 变量具有面、结构和标准效度；高可靠性和对变化的敏感性；以及区分治疗方法的能力。这使得 RAMRIS 能够以比常规 X 射线更少的患者和更短的随访时间来证明结构损伤进展的抑制。技术改进，包括更高的磁场强度和改进的脉冲序列，允许更高的图像分辨率和对比度噪声比。这促进了新病理的评分方法：关节间隙狭窄和肌腱滑膜炎的发展和验证。这些方法具有较高的可重复性和对变化的中等敏感性，并且可以添加到 RAMRIS 中。炎症或关节损伤的综合评分可能会提高对变化的敏感性和区分力。然而，这需要进一步的研究。
结论
制定了更新的 2016 年 RAMRIS 建议和研究议程。
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