磁共振成像测定类风湿关节炎和骨关节炎的滑膜及关节积液量：与滑膜宏观和微观表现的比较

Magnetic resonance imaging-determined synovial membrane and joint effusion volumes in rheumatoid arthritis and osteoarthritis: comparison with the macroscopic and microscopic appearance of the synovium.

作者信息

Ostergaard M, Stoltenberg M, Løvgreen-Nielsen P, Volck B, Jensen C H, Lorenzen I

机构信息

Hvidovre Hospital, Denmark.

出版信息

Arthritis Rheum. 1997 Oct;40(10):1856-67. doi: 10.1002/art.1780401020.

DOI:10.1002/art.1780401020

PMID:9336422

Abstract

OBJECTIVE

To evaluate the relationship between synovial membrane and joint effusion volumes determined by magnetic resonance imaging (MRI) and macroscopic and microscopic synovial pathologic findings in patients with rheumatoid arthritis (RA) and osteoarthritis (OA).

METHODS

Synovial biopsies were performed, and macroscopic grades of synovitis assigned, at preselected knee sites during arthroscopy or arthrotomy in 17 knees with RA and 25 with OA. Synovial inflammation and 9 separate tissue characteristics were graded histologically. Synovial membrane and joint effusion volumes were determined by preoperative MRI, enhanced with intravenous gadopentetate dimeglumine.

RESULTS

MRI-determined synovial membrane volumes were correlated with the overall histologic assessment of synovial inflammation (Spearman's sigma = 0.55, P < 0.001), with fibrin deposition, with subsynovial mononuclear and polymorphonuclear leukocyte infiltration (sigma = 0.51-0.59), and less significantly with macroscopic synovitis, vessel proliferation, and granulation tissue formation (sigma = 0.40-0.42). No correlation with synovial lining multiplication, perivascular edema, villous formation, or fibrosis was found (sigma < 0.30).

CONCLUSION

MRI-determined synovial volumes are correlated with synovial inflammatory activity. Synovial volumes probably mainly reflect the mass of cell-infiltrated, vascularized subsynovial tissue, but may also be influenced by the cumulative synovial proliferative activity. MRI-determined synovial membrane and effusion volumes may be sensitive markers and/or predictors of disease activity and treatment outcome in RA.

摘要

目的

评估类风湿关节炎（RA）和骨关节炎（OA）患者中，磁共振成像（MRI）测定的滑膜体积与关节积液量，以及滑膜大体和微观病理表现之间的关系。

方法

在关节镜检查或切开手术时，于预先选定的膝关节部位对17例RA患者和25例OA患者的膝关节进行滑膜活检，并对滑膜炎进行大体分级。对滑膜炎症和9种不同的组织特征进行组织学分级。术前通过静脉注射钆喷酸葡胺增强的MRI测定滑膜体积和关节积液量。

结果

MRI测定的滑膜体积与滑膜炎症的整体组织学评估相关（Spearman氏σ = 0.55，P < 0.001），与纤维蛋白沉积、滑膜下单核细胞和多形核白细胞浸润相关（σ = 0.51 - 0.59），与大体滑膜炎、血管增生和肉芽组织形成的相关性较弱（σ = 0.40 - 0.42）。未发现与滑膜衬里增生、血管周围水肿、绒毛形成或纤维化相关（σ < 0.30）。