Department of Rheumatology, Medical University of Graz, Graz, Austria
Department of Rheumatology (ASAA-SABES), Brunico Hospital, Brunico, Italy.
Ann Rheum Dis. 2022 Jun;81(6):760-767. doi: 10.1136/annrheumdis-2021-221261. Epub 2021 Dec 10.
To develop evidence-based Points to Consider (PtC) for the use of imaging modalities to guide interventional procedures in patients with rheumatic and musculoskeletal diseases (RMDs).
European Alliance of Associations for Rheumatology (EULAR) standardised operating procedures were followed. A systematic literature review was conducted to retrieve data on the role of imaging modalities including ultrasound (US), fluoroscopy, MRI, CT and fusion imaging to guide interventional procedures. Based on evidence and expert opinion, the task force (25 participants consisting of physicians, healthcare professionals and patients from 11 countries) developed PtC, with consensus obtained through voting. The final level of agreement was provided anonymously.
A total of three overarching principles and six specific PtC were formulated. The task force recommends preference of imaging over palpation to guide targeted interventional procedures at peripheral joints, periarticular musculoskeletal structures, nerves and the spine. While US is the favoured imaging technique for peripheral joints and nerves, the choice of the imaging method for the spine and sacroiliac joints has to be individualised according to the target, procedure, expertise, availability and radiation exposure. All imaging guided interventions should be performed by a trained specialist using appropriate operational procedures, settings and assistance by technical personnel.
These are the first EULAR PtC to provide guidance on the role of imaging to guide interventional procedures in patients with RMDs.
制定循证要点（PtC），以指导风湿和肌肉骨骼疾病（RMD）患者介入治疗中各种影像学手段的应用。
遵循欧洲抗风湿病联盟（EULAR）标准操作程序。进行了系统的文献检索，以获取有关影像学手段（包括超声（US）、透视、MRI、CT 和融合成像）在介入治疗中作用的数据。基于证据和专家意见，工作组（由来自 11 个国家的 25 名医生、医疗保健专业人员和患者组成）制定了 PtC，并通过投票达成共识。最终的一致程度是匿名提供的。
共制定了三项总体原则和六项具体 PtC。工作组建议，在指导外周关节、关节周围肌肉骨骼结构、神经和脊柱的靶向介入治疗时，优先选择影像学而非触诊。虽然 US 是外周关节和神经的首选影像学技术，但脊柱和骶髂关节的影像学方法的选择必须根据目标、手术、专业知识、可用性和辐射暴露情况个体化。所有影像学引导的介入治疗应由经过培训的专家使用适当的操作程序、设置以及技术人员的协助进行。
这些是 EULAR 首次制定的 PtC，旨在指导 RMD 患者介入治疗中影像学的作用。
