Rominger M B, Bernreuter W K, Kenney P J, Morgan S L, Blackburn W D, Alarcon G S
Department of Radiology, University of Alabama, Birmingham 35233.
Radiographics. 1993 Jan;13(1):37-46. doi: 10.1148/radiographics.13.1.8426935.
Several magnetic resonance (MR) imaging pulse sequences (unenhanced T1 weighted spin echo, with and without fat suppression; unenhanced T2 weighted with fat suppression; and spoiled gradient-recalled acquisition in the steady state [GRASS], with fat suppression, before and after gadolinium enhancement) were analyzed in 30 patients with early rheumatoid arthritis to determine which sequences were best for imaging various aspects of the disease as manifested in the hands and wrists. A single hand was imaged in all patients. Inflammation and erosions were best seen on spoiled GRASS images with fat suppression and gadolinium enhancement, with the latter also being well seen on T1-weighted images. Articular cartilage was best seen on unenhanced spoiled GRASS or T1-weighted images with fat suppression. For the latter application, increased resolution is needed before the results will be meaningful. MR imaging has potential as an objective method for evaluating rheumatoid arthritis. However, change in MR imaging findings in a single hand must be carefully monitored and compared with the overall disease course for a long period in a large number of patients to establish the clinical value of MR imaging.
对30例早期类风湿性关节炎患者的几种磁共振（MR）成像脉冲序列（未增强的T1加权自旋回波，有或无脂肪抑制；未增强的T2加权脂肪抑制；以及钆增强前后有脂肪抑制的稳态扰相梯度回波[GRASS]）进行了分析，以确定哪些序列最适合对双手和双腕表现出的该疾病的各个方面进行成像。所有患者均对一只手进行了成像。在有脂肪抑制和钆增强的扰相GRASS图像上，炎症和侵蚀最为明显，钆增强在T1加权图像上也能很好地显示。在未增强的扰相GRASS或有脂肪抑制的T1加权图像上，关节软骨显示最佳。对于后一种应用，在结果有意义之前需要提高分辨率。MR成像有潜力作为评估类风湿性关节炎的一种客观方法。然而，必须仔细监测单只手MR成像结果的变化，并与大量患者的长期整体病程进行比较，以确定MR成像的临床价值。
