Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Valdemar Hansens vej 17, 2600, Glostrup, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Radiol Med. 2019 Nov;124(11):1128-1141. doi: 10.1007/s11547-019-01014-y. Epub 2019 Mar 18.
In suspected and diagnosed rheumatoid arthritis (RA), magnetic resonance imaging (MRI) allows detection of all relevant pathologies, such as synovitis, tenosynovitis, bone marrow edema (osteitis), bone erosion and cartilage damage. MRI is more sensitive than clinical examination for monitoring disease activity (i.e., inflammation) and more sensitive than conventional radiography and ultrasonography for monitoring joint destruction. In suspected RA, MRI bone marrow edema predicts development of RA, and in early RA patients, it predicts subsequent structural damage progression. CT is the standard reference imaging modality for visualizing bone damage, including bone erosions in RA, but lacks sensitivity for soft-tissue changes, including synovitis and tenosynovitis. CT has a minimal role in RA clinical trials and practice, except in selected patients where MRI is contraindicated or not available or if crystal arthritis such as gout or pseudo-gout is suspected. MRI has documented utility in diagnosis, monitoring and prognostication of patients with RA and is increasingly used for these purposes in clinical practice and particularly clinical trials.
在疑似和确诊的类风湿关节炎（RA）中，磁共振成像（MRI）可检测到所有相关的病理改变，如滑膜炎、腱鞘炎、骨髓水肿（骨炎）、骨侵蚀和软骨损伤。与临床检查相比，MRI 更敏感，可用于监测疾病活动（即炎症），与常规 X 线摄影和超声相比，MRI 更敏感，可用于监测关节破坏。在疑似 RA 中，MRI 骨髓水肿可预测 RA 的发展，在早期 RA 患者中，可预测随后的结构损伤进展。CT 是用于观察骨损伤的标准参考成像方式，包括 RA 的骨侵蚀，但对包括滑膜炎和腱鞘炎在内的软组织变化缺乏敏感性。CT 在 RA 临床试验和实践中的作用有限，除非在 MRI 禁忌、不可用或怀疑痛风或假性痛风等晶体性关节炎的特定患者中。MRI 已被证明可用于诊断、监测和预测 RA 患者，并在临床实践中越来越多地用于这些目的，特别是在临床试验中。
