Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Division of Diagnostic Radiology, Department of Radiology, Keio University School of Medicine, Tokyo, Japan.
Rheumatology (Oxford). 2021 Dec 1;60(12):5595-5600. doi: 10.1093/rheumatology/keab164.
We sought to clarify the presence of radiographic thymus variants using a scoring system, and their association with clinical and immunological features in RA patients.
A total of 387 RA patients were randomly selected from all patients visiting our department who underwent chest CT scanning, with exclusion of patients with thymoma or thymic cyst, or age < 30 years. Thymus size and attenuation score in axial CT images were quantitatively interpreted and assessed. Associations between immunophenotype data and clinical and serological features were analysed in a subset of patients.
Thymic enlargement was found in 76 (19.6%) patients, and a thymus attenuation score ≥ 2 was found in 50 (12.9%) patients. The score was significantly associated with antibodies to ACPA positivity. Thymic enlargement was significantly associated with the proportions of CD4+ effector memory T cells.
Radiographic thymus variants were frequently observed in RA patients and may reflect an abnormal immune response involved in the pathogenesis of RA.
我们试图通过评分系统阐明影像学胸腺变异的存在，并研究其与 RA 患者临床和免疫特征的相关性。
从所有在我科行胸部 CT 扫描的患者中随机选择了 387 名 RA 患者，排除了胸腺瘤或胸腺囊肿患者或年龄 < 30 岁的患者。对轴向 CT 图像中的胸腺大小和衰减评分进行定量解释和评估。对部分患者的免疫表型数据与临床和血清学特征之间的关系进行了分析。
76 名（19.6%）患者存在胸腺肿大，50 名（12.9%）患者的胸腺衰减评分≥2。该评分与 ACPA 阳性抗体显著相关。胸腺肿大与 CD4+效应记忆 T 细胞的比例显著相关。
RA 患者中经常观察到影像学胸腺变异，这可能反映了 RA 发病机制中涉及的异常免疫反应。
