Department of Imaging & Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, N.T., Hong Kong.
Department of Jockey Club Centre for Osteoporosis Care and Control, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, N.T., Hong Kong.
Eur Radiol. 2019 Oct;29(10):5646-5654. doi: 10.1007/s00330-019-06060-8. Epub 2019 Mar 14.
To (i) devise a new semi-quantitative scoring system known as Early Rheumatoid Arthritis Magnetic Resonance Score (ERAMRS) to assess inflammation of the wrist on magnetic resonance imaging in early rheumatoid arthritis and to (ii) test ERAMRS and other MR scoring systems against everyday used clinical scorings.
One hundred six treatment-naïve patients (81 females, 25 males, mean age 53 ± 12 years) with early rheumatoid arthritis (ERA) underwent clinical/serological testing as well as 3-T MRI examination of the most symptomatic wrist. Clinical assessment included Disease Activity Score-28 and Health Assessment Questionnaire; erythrocyte sedimentation rate and C-reactive protein were measured. MR imaging data was scored in all patients using three devised MR semi-quantitative scoring systems, namely, the (a) ERAMRS system, (b) Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) system, and the (c) McQueen Score system.
Synovitis was present in 106 (100%), tenosynovitis in 98 (92%), and bone marrow edema in 84 (79%) of 106 ERA wrists. ERAMRS had the highest correlation with clinical disease activity scores (r = 0.476, p < 0.001) and serological parameters (r = 0.562, p < 0.001). RAMRIS system had the lowest correlation (r = 0.369, p < 0.001 for clinical disease activity; r = 0.436, p < 0.001 for serological parameters). RAMRIS synovitis subscore had a lower correlation than ERAMRS for clinical disease activity (r = 0.410, p < 0.001) and for serological parameters (r = 0.456, p < 0.001).
The ERAMRS system, designed to grade inflammation on wrist MRI in ERA, provided the best correlation with all clinical scoring systems and serological parameters, indicating its improved clinical relevance over other MR scoring systems.
• We devised a clinically relevant, easy-to-use semi-quantitative scoring system for scoring inflammation on MRI of the wrist in patients with early rheumatoid arthritis. • ERAMRS system showed better correlation with all clinical and serological assessment of inflammation in patients with early rheumatoid arthritis indicating its improved clinical relevance over other MR scoring systems.
（i）设计一种新的半定量评分系统，称为早期类风湿关节炎磁共振评分（ERAMRS），用于评估早期类风湿关节炎腕关节磁共振成像中的炎症，并（ii）测试 ERAMRS 和其他磁共振评分系统与日常使用的临床评分相比。
106 名未经治疗的早期类风湿关节炎（ERA）患者（81 名女性，25 名男性，平均年龄 53±12 岁）接受了临床/血清学检查以及最有症状的腕关节 3-T MRI 检查。临床评估包括疾病活动评分 28 和健康评估问卷；测量红细胞沉降率和 C 反应蛋白。所有患者均使用三种新设计的磁共振半定量评分系统（a）ERAMRS 系统、（b）类风湿关节炎磁共振成像评分（RAMRIS）系统和（c）McQueen 评分系统对磁共振成像数据进行评分。
106 例 ERA 腕关节中均存在滑膜炎（100%）、腱鞘炎（92%）和骨髓水肿（79%）。ERAMRS 与临床疾病活动评分（r=0.476，p<0.001）和血清学参数（r=0.562，p<0.001）相关性最高。RAMRIS 系统相关性最低（r=0.369，临床疾病活动 p<0.001；r=0.436，血清学参数 p<0.001）。RAMRIS 滑膜炎亚评分与 ERAMRS 相比，与临床疾病活动（r=0.410，p<0.001）和血清学参数（r=0.456，p<0.001）的相关性较低。
ERAMRS 系统旨在对 ERA 腕关节 MRI 上的炎症进行分级，与所有临床评分系统和血清学参数相关性最佳，表明其与其他磁共振评分系统相比，临床相关性得到了提高。
（i）我们设计了一种用于评估早期类风湿关节炎患者腕关节 MRI 炎症的临床相关、易于使用的半定量评分系统。（ii）ERAMRS 系统与早期类风湿关节炎患者所有临床和血清学炎症评估的相关性更好，表明与其他磁共振评分系统相比，其临床相关性得到了提高。
