Hirose J, Nishioka H, Tsukano M, Matsubara S, Usuku K, Mizuta H
Department of Orthopedic Surgery, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
Department of Orthopedic Surgery, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
Clin Radiol. 2018 Nov;73(11):984.e11-984.e18. doi: 10.1016/j.crad.2018.06.020. Epub 2018 Jul 30.
To estimate the morphological changes in the articular cartilage of the knees of patients with rheumatoid arthritis treated with biological disease-modifying anti-rheumatic drugs (bDMARDs).
Cartilage-specific magnetic resonance imaging (MRI) results, including T2 and T1ρ mapping of the femorotibial joint of 17 patients, were obtained before and 1 year after starting treatment with bDMARDs. Regions of interest were selected on the sagittal images of the cartilage of the medial and lateral femoral condyles (MFC, LFC) and the tibial plateau (MTP, LTP). Cartilage thickness, T2, and T1ρ were measured, and the correlations of their changes were evaluated.
The mean changes in cartilage thickness tended to decrease in all four condyles, and the rate was significant in the MFC. T2 and T1ρ tended to increase, and T2 in the MFC significantly increased. Changes in cartilage thickness after 1 year showed a moderate correlation with the baseline T2 in the MFC as well as changes in T2 in the MTP.
Decreasing cartilage thickness and matrix changes appeared in the MFC after 1 year of treatment with bDMARDs. Microstructural damage of the cartilage at baseline is a predictor for further cartilage damage in the knee joint, even if treatment with bDMARDs is effective.
评估接受生物性改善病情抗风湿药物(bDMARDs)治疗的类风湿关节炎患者膝关节软骨的形态学变化。
获取17例患者在开始使用bDMARDs治疗前及治疗1年后的软骨特异性磁共振成像(MRI)结果,包括股骨胫关节的T2和T1ρ成像。在股骨内侧髁(MFC)、外侧髁(LFC)及胫骨平台(MTP、LTP)软骨的矢状位图像上选择感兴趣区。测量软骨厚度、T2及T1ρ,并评估其变化的相关性。
所有四个髁的软骨厚度平均变化均呈下降趋势,其中MFC的下降速率具有显著性。T2和T1ρ呈上升趋势,MFC的T2显著升高。治疗1年后软骨厚度的变化与MFC的基线T2以及MTP的T2变化呈中度相关。
使用bDMARDs治疗1年后,MFC出现软骨厚度降低及基质变化。即使bDMARDs治疗有效,基线时软骨的微观结构损伤仍是膝关节进一步软骨损伤的预测指标。