Centre for Medical Imaging, University College London, University College London, London, UK.
Centre for Adolescent Rheumatology, Division of Medicine, University College London, London, UK.
Rheumatology (Oxford). 2024 Sep 1;63(SI2):SI207-SI214. doi: 10.1093/rheumatology/keae039.
To assess the frequency of joint inflammation detected by whole-body MRI (WBMRI) in young people (YP) with JIA and controls, and to determine the relationship between WBMRI-detected inflammation and clinical findings.
YP aged 14-24 years, with JIA (patients) or arthralgia without JIA (controls), recruited from one centre, underwent a WBMRI scan after formal clinical assessment. Consensus between at least two of the three independent radiologists was required to define inflammation and damage on WBMRI, according to predefined criteria. YP with JIA were deemed clinically active as per accepted definitions. The proportions of YP with positive WBMRI scans for joint inflammation (one or more inflamed joint) as well as serum biomarkers were compared between active vs inactive JIA patients and controls.
Forty-seven YP with JIA (25 active and 22 inactive patients) and 13 controls were included. WBMRI detected joint inflammation in 60% (28/47) of patients with JIA vs 15% (2/13) of controls (difference: 44%, 95% CI 20%, 68%). More active than inactive JIA patients had WBMRI-detected inflammation [76% (19/25) vs 41% (9/22), difference: 35% (95% CI 9%, 62%)], and this was associated with a specific biomarker signature. WBMRI identified inflammation in one or more clinically inactive joint in 23/47 (49%) patients (14/25 active vs 9/22 inactive JIA patients).
WBMRI's validity in joint assessment was demonstrated by the higher frequency of inflammation in JIA patients vs controls, and in active vs inactive JIA patients. WBMRI found unsuspected joint inflammation in 49% YP with JIA, which needs further investigation of potential clinical implications.
评估幼年特发性关节炎（JIA）患者和对照者全身磁共振成像（WBMRI）检测到的关节炎症频率，并确定 WBMRI 检测到的炎症与临床发现之间的关系。
从一个中心招募年龄在 14-24 岁的 JIA 患者（患者）或有 JIA 但无关节痛的对照者（对照者），在正式临床评估后进行 WBMRI 扫描。根据预先设定的标准，至少有三位独立放射科医生中的两位达成共识，以定义 WBMRI 上的炎症和损伤。根据公认的定义，JIA 患者被认为是临床活动的。比较活跃 JIA 患者与不活跃 JIA 患者和对照者之间的 WBMRI 扫描阳性率（一个或多个炎症关节）和血清生物标志物。
共纳入 47 例 JIA 患者（25 例活动期和 22 例非活动期患者）和 13 例对照者。WBMRI 检测到 JIA 患者中有 60%（28/47）存在关节炎症，而对照者中为 15%（2/13）（差异：44%，95%CI 20%，68%）。活动期 JIA 患者比非活动期 JIA 患者有更多的 WBMRI 检测到的炎症[76%（19/25）比 41%（9/22），差异：35%（95%CI 9%，62%）]，且与特定的生物标志物特征相关。WBMRI 在 47 例患者中的 1 个或多个临床无症状关节中发现炎症（49%，23/47）（14 例活动期 JIA 患者和 9 例非活动期 JIA 患者）。
WBMRI 在关节评估中的有效性通过 JIA 患者与对照者相比炎症频率更高，以及活动期 JIA 患者与非活动期 JIA 患者相比炎症频率更高来证明。WBMRI 在 49%的 JIA 患者中发现了未被怀疑的关节炎症，这需要进一步研究其潜在的临床意义。
