Reijnierse Monique, Helm-Mil Annette van der, Eshed Iris, Schueller-Weidekamm Claudia
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Semin Musculoskelet Radiol. 2018 Apr;22(2):127-146. doi: 10.1055/s-0038-1639474. Epub 2018 Apr 19.
Both the fields of rheumatology and radiology are changing rapidly. Effective medication has become available for rheumatoid arthritis (RA) and transformed it from a progressive disabling disease into a chronic disease. Indications for magnetic resonance imaging (MRI) have changed accordingly, shifting toward early detection. There is also an overall increased clinical demand for high-end imaging. Together with improvement of MRI units and sequences, MRI protocols are adapted based on clinical indications. This article addresses (1) the clinical background and present role of MRI in early disease detection, (2) RA involvement of peripheral joints, (3) RA involvement of the spine, and (4) state-of-the-art RA MRI protocols. The key toward cost-effective MRI examination in RA is communication between radiologist and rheumatologist as well as awareness and knowledge of the basics and advancements in both fields.
风湿病学和放射学领域都在迅速变化。类风湿性关节炎（RA）已有了有效的药物，使其从一种进行性致残疾病转变为一种慢性病。磁共振成像（MRI）的适应证也相应发生了变化，转向早期检测。对高端成像的临床总体需求也在增加。随着MRI设备和序列的改进，MRI检查方案根据临床适应证进行了调整。本文探讨了（1）MRI在疾病早期检测中的临床背景和当前作用，（2）RA累及外周关节的情况，（3）RA累及脊柱的情况，以及（4）RA的最新MRI检查方案。在RA中实现具有成本效益的MRI检查的关键在于放射科医生和风湿病医生之间的沟通，以及对这两个领域的基础知识和进展的认识与了解。
