摘要
目的分析类风湿性关节炎手腕部MRI及弥散加权成像(DWI)表现,并与临床滑膜病理指标作相关性分析,探讨MRI对评估双手、腕类风湿关节炎的严重程度及临床活动性的价值。方法对15例确诊RA患者行双手MRI检查,并与临床症状和实验室检查进行相关性分析,测量DWI上滑膜ADC值,与滑膜穿刺活检的病理学指标进行相关性分析。结果 MRI滑膜炎评分、骨侵蚀评分、骨髓水肿评分及总分均与C反应蛋白(CRP)、可视化量表(VAS)有相关性;DWI的ADC值与滑膜病理评分具有负相关。结论 MRI能清楚显示RA手腕部小关节的病理改变。MRI可对RA的滑膜炎、骨侵蚀、骨髓水肿进行半定量化分级评分,MRI评分与临床指标有一定相关性,对双手、腕类风湿关节炎的活动性评估具有重要价值。DWI结合ADC值测量,可更加直接地反映病变关节的活动程度。
Objective To analyze magnetic resonance imaging and diffusion-weighted imaging of hand and wrist joints in rheumatoid arthritis(RA)patients to investigate the value of MR imaging in the evaluation the disease severity and activity by correlating the MR findings with clinical and synovium histological features.Methods Fifteen patients with RA were enrolled.All patients underwent MR examination on both wrists and the 2th to 5th metacarpophalangeals(MCP).The clinical and laboratory parameters of each patient were record and correlated with MR parameters.On DWI,the ADC of involved joints were measured and correlated with the histological parameters that were observed on the histological examination from synovial biopsy.Results Synovitis score of MRI,bone erosion score,bone marrow edema score and the total score were correlated with CRP and VAS.ADC value measured on DWI was negatively correlated with histological synovitis score.Conclusions MRI can clearly display the pathological changes of the hand and wrist joints in RA patients.MRI can be used to semiquantitatively assess the synovitis,bone erosion and bone marrow edema.MRI-based scoring was correlated with clinical and laboratory features and play an important role in evaluation the disease activity.DWI in combination with ADC measurements can more directly reflect the joint disease activity.
作者
陈悦熙
张芳
沈君
CHEN Yue-xi;ZHANG Fang;SHEN Jun(Department of Radiology,Guangzhou No.12People's Hospital,Guangzhou 510620,China)
出处
《中华临床医师杂志（电子版）》
CAS
2012年第22期7270-7274,共5页
Chinese Journal of Clinicians(Electronic Edition)
关键词
关节炎
类风湿
腕关节
磁共振成像
Arthritis,rheumatoid
Carpal joints
Magnetic resonance imaging
