2D FSE T2 加权 Dixon MRI 与对比增强 2D FSE 和 3D FSPGR T1 加权 Dixon MRI 定量评估早期类风湿关节炎患者手部炎症的比较。
Comparison between 2D FSE T2-weighted Dixon MRI and contrast-enhanced 2D FSE and 3D FSPGR T1-weighted Dixon MRI to quantify inflammation in hands of patients with early rheumatoid arthritis.
机构信息
Department of Medical Imaging - Musculoskeletal Imaging Unit, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Institut de Recherche Expérimentale et Clinique (IREC), 1200 Brussels, Belgium.
Department of Rheumatology - Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Institut de Recherche Expérimentale et Clinique (IREC), 1200 Brussels, Belgium.
出版信息
Diagn Interv Imaging. 2023 Jul-Aug;104(7-8):351-358. doi: 10.1016/j.diii.2023.03.005. Epub 2023 Mar 28.
PURPOSE
The purpose of this study was to compare two-dimensional (2D) T2-weighted, contrast-enhanced 2D T1-weighted and contrast-enhanced three-dimensional (3D) T1-weighted Dixon MRI sequences to assess disease activity using the RAMRIS scoring system in hands of patients with early rheumatoid arthritis.
MATERIALS AND METHODS
Twenty-five patients (19 women, 6 men; mean age 51.4 years ± 12.7 years [SD], age range: 28-70 years) with rheumatoid arthritis prospectively underwent MRI examination of both hands at 1.5 T using 2D fast spin-echo (FSE) T2-weighted, contrast-enhanced 2D FSE T1-weighted and contrast-enhanced 3D fast spoiled gradient echo (FSPGR) T1-weighted Dixon sequences. Three radiologists independently assessed disease activity according to RAMRIS using Dixon water-only and fat-only images. Intraclass correlation coefficients (ICC) were calculated to assess inter-technique and interobserver agreements.
RESULTS
Agreement to assess total RAMRIS score was very good between the MRI protocols (mean ICC ranging from 0.81 to 0.93) and between readers (mean ICC ranging from 0.91 to 0.94). Mean total RAMRIS scores of the three readers were significantly greater with contrast-enhanced 3D FSPGR T1-weighted (42.73 ± 29.39) than with contrast-enhanced 2D FSE T1-weighted (35.81 ± 25.48) and 2D FSE T2-weighted (32.20 ± 25.06) Dixon sequences.
CONCLUSION
2D FSE T2-weighted, contrast-enhanced 2D FSE T1-weighted Dixon and contrast-enhanced 3D FSPGR T1-weighted Dixon protocols are reproducible alternatives for the RAMRIS scoring in hands of patients with early rheumatoid arthritis. Coupling contrast-enhanced 3D FSPGR T1-weighted and 2D FSE T2-weighted sequences might be the most efficient option to completely assess the rheumatoid arthritis -related synovial and bone changes with the Dixon method.
目的
本研究旨在比较二维（2D）T2 加权、对比增强二维 T1 加权和对比增强三维（3D）T1 加权 Dixon MRI 序列，使用 RAMRIS 评分系统评估早期类风湿关节炎患者手部的疾病活动度。
材料与方法
25 例（19 名女性，6 名男性；平均年龄 51.4 岁±12.7 岁[标准差]，年龄范围：28-70 岁）类风湿关节炎患者前瞻性地在 1.5T 上使用 2D 快速自旋回波（FSE）T2 加权、对比增强 2D FSE T1 加权和对比增强 3D 快速扰相梯度回波（FSPGR）T1 加权 Dixon 序列进行双手 MRI 检查。3 名放射科医生分别根据 RAMRIS 使用 Dixon 水图像和脂肪图像评估疾病活动度。计算组内相关系数（ICC）以评估技术间和观察者间的一致性。
结果
MRI 方案（平均 ICC 范围为 0.81 至 0.93）和观察者间（平均 ICC 范围为 0.91 至 0.94）评估总 RAMRIS 评分的一致性非常好。三位读者的平均总 RAMRIS 评分均以增强 3D FSPGR T1 加权（42.73±29.39）显著高于增强 2D FSE T1 加权（35.81±25.48）和 2D FSE T2 加权（32.20±25.06）Dixon 序列。
结论
2D FSE T2 加权、对比增强 2D FSE T1 加权 Dixon 和对比增强 3D FSPGR T1 加权 Dixon 方案是评估早期类风湿关节炎患者 RAMRIS 评分的可重复替代方案。联合使用增强 3D FSPGR T1 加权和 2D FSE T2 加权序列可能是使用 Dixon 方法完全评估类风湿关节炎相关滑膜和骨改变的最有效选择。
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