Abrar Daniel B, Schleich Christoph, Frenken Miriam, Vordenbäumen Stefan, Richter Jutta, Schneider Matthias, Ostendorf Benedikt, Nebelung Sven, Sewerin Philipp
Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, 40225 Düsseldorf, Germany.
Department and Hiller Research Unit for Rheumatology, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Diagnostics (Basel). 2021 Jan 20;11(2):147. doi: 10.3390/diagnostics11020147.
Even though cartilage loss is a known feature of psoriatic (PsA) and rheumatoid arthritis (RA), research is sparse on its role in the pathogenesis of PsA, its potential use for disease monitoring and for differentiation from RA. We therefore assessed the use of delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) to evaluate biochemical cartilage changes in metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints in PsA patients and compared these to RA patients.
A total of 17 patients with active PsA and 20 patients with active RA were evaluated by high-resolution 3 Tesla dGEMRIC using a dedicated 16-channel hand coil. Images were analyzed by two independent raters for dGEMRIC indices and joint space width (JSW) at MCP and PIP joint levels.
No significant differences of dGEMRIC values could be found between both study populations (PsA 472.25 ms, RA 461.11 ms; = 0.763). In all RA and most PsA patients, PIP joints showed significantly lower dGEMRIC indices than MCP joints (RA: D2: = 0.009, D3: = 0.008, D4: = 0.002, D5: = 0.002; PsA: D3: = 0.001, D4: = 0.004). Most joint spaces had similar widths in both disease entities and no significant differences were found.
As evaluated by dGEMRIC, the molecular composition of the MCP and PIP joint cartilage of PsA patients is similar to that of RA patients, demonstrating the scientific and clinical feasibility of compositional magnetic resonance (MR) imaging in these disease entities. Patterns and severity of compositional cartilage degradation of the finger joints may therefore be assessed beyond mere morphology in PsA and RA patients.
尽管软骨损伤是银屑病关节炎（PsA）和类风湿关节炎（RA）的已知特征，但关于其在PsA发病机制中的作用、在疾病监测中的潜在用途以及与RA鉴别的研究却很少。因此，我们评估了延迟钆增强磁共振成像（dGEMRIC）在评估PsA患者掌指关节（MCP）和近端指间关节（PIP）软骨生化变化中的应用，并将这些结果与RA患者进行比较。
使用专用的16通道手部线圈，通过高分辨率3特斯拉dGEMRIC对17例活动期PsA患者和20例活动期RA患者进行评估。由两名独立的评估者分析MCP和PIP关节水平的dGEMRIC指数和关节间隙宽度（JSW）图像。
在两个研究人群之间未发现dGEMRIC值有显著差异（PsA为472.25毫秒，RA为461.11毫秒；P = 0.763）。在所有RA患者和大多数PsA患者中，PIP关节的dGEMRIC指数显著低于MCP关节（RA：D2：P = 0.009，D3：P = 0.008，D4：P = 0.002，D5：P = 0.002；PsA：D3：P = 0.001，D4：P = 0.004）。在两种疾病中，大多数关节间隙宽度相似，未发现显著差异。
通过dGEMRIC评估，PsA患者MCP和PIP关节软骨的分子组成与RA患者相似，这表明成分磁共振成像在这些疾病中的科学和临床可行性。因此，在PsA和RA患者中，除了单纯的形态学外，还可以评估手指关节成分性软骨降解的模式和严重程度。
