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全身 MRI 用于炎性关节炎关节累及的检查。

Whole-body MRI for the investigation of joint involvement in inflammatory arthritis.

机构信息

Leeds NIHR Musculoskeletal Biomedical Research Centre, Leeds, UK.

Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.

出版信息

Skeletal Radiol. 2024 May;53(5):935-945. doi: 10.1007/s00256-023-04515-0. Epub 2023 Nov 22.

Abstract

OBJECTIVES

This study aimed to develop a novel whole-body MRI protocol capable of assessing inflammatory arthritis at an early stage in multiple joints in one examination.

MATERIALS AND METHODS

Forty-six patients with inflammatory joint symptoms and 9 healthy volunteers underwent whole-body MR imaging on a 3.0 T MRI scanner in this prospective study. Image quality and pathology in each joint, bursae, entheses and tendons were scored by two of three radiologists and compared to clinical joint scores. Participants were divided into three groups based on diagnosis at 1-year follow-up (healthy volunteers, rheumatoid arthritis and all other types of arthritis). Radiology scores were compared between the three groups using a Kruskal-Wallis test. The clinical utility of radiology scoring was compared to clinical scoring using ROC analysis.

RESULTS

A protocol capable of whole-body MR imaging of the joints with an image acquisition time under 20 min was developed with excellent image quality. Synovitis scores were significantly higher in patients who were diagnosed with rheumatoid arthritis at 12 months (p < 0.05). Radiology scoring of bursitis showed statistically significant differences between each of the three groups-healthy control, rheumatoid arthritis and non-rheumatoid arthritis (p < 0.05). There was no statistically significant difference in ROC analysis between MRI and clinical scores.

CONCLUSION

This study has developed a whole-body MRI joint imaging protocol that is clinically feasible and shows good differentiation of joint pathology between healthy controls, patients with rheumatoid arthritis and patients with other forms of arthritis.

摘要

目的

本研究旨在开发一种新的全身 MRI 方案,能够在一次检查中评估多个关节的早期炎症性关节炎。

材料与方法

在这项前瞻性研究中,46 例有炎症性关节症状的患者和 9 例健康志愿者在 3.0 T MRI 扫描仪上进行了全身 MRI 检查。两位放射科医生对每个关节、滑囊、肌腱附着点和肌腱的图像质量和病理学进行了评分,并与临床关节评分进行了比较。根据 1 年随访时的诊断,将参与者分为三组(健康志愿者、类风湿关节炎和所有其他类型的关节炎)。使用 Kruskal-Wallis 检验比较三组之间的放射学评分。使用 ROC 分析比较放射学评分与临床评分的临床实用性。

结果

开发了一种能够在 20 分钟内完成全身关节 MRI 扫描的方案,具有出色的图像质量。在 12 个月时被诊断为类风湿关节炎的患者的滑膜炎评分明显更高(p<0.05)。在三个组(健康对照组、类风湿关节炎组和非类风湿关节炎组)之间,滑囊炎的放射学评分存在统计学显著差异(p<0.05)。MRI 和临床评分之间的 ROC 分析没有统计学显著差异。

结论

本研究开发了一种全身 MRI 关节成像方案,该方案在临床上可行,能够很好地区分健康对照组、类风湿关节炎患者和其他类型关节炎患者的关节病理学。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a33/10972907/ef698bd874e0/256_2023_4515_Fig1_HTML.jpg

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