原文

譯文

Ann Rheum Dis. 2011 Jan;70(1):176-9. Epub 2010 Nov 10.

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Prediction of MRI erosive progression: a comparison of modern imaging modalities in early rheumatoid arthritis patients.

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B?yesen P, Haavardsholm EA, van der Heijde D, ?stergaard M, Hammer HB, Sesseng S, Kvien TK.

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Source

Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. pernilleboyesen@gmail.com

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Abstract

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OBJECTIVES:

To examine the associations between modern imaging modalities and joint damage measured as 1-year MRI erosive progression, in early rheumatoid arthritis (RA) patients.

METHODS:

84 RA patients with disease duration of less than 1 year were included in this inception cohort. Patients were evaluated at baseline, 3, 6 and 12 months by core measures of disease activity, MRI and ultrasound grey-scale (USGS) of inflammation, conventional radiography and digital x-ray radiogrammetry (DXR) bone mineral density (BMD) of cortical hand bone.

RESULTS:

53 of the 79 patients (67%) who completed the follow-up had MRI erosive progression (dependent variable). USGS and MRI bone marrow oedema (BME) were in multivariate analyses independent predictors of 1-year MRI erosive progression. There was a trend towards higher MRI synovitis score and 3-month DXR BMD loss in patients developing MRI erosions. On an individual level, USGS inflammation, MRI synovitis and MRI BME also somewhat better predicted outcome than rheumatoid factor, anticitrullinated protein antibodies and disease activity score 28.

CONCLUSIONS:

USGS inflammation and MRI BME were independent predictors of MRI erosive progression in early RA patients on a group level. The exact prognosis of the individual patients could not be determined by imaging alone.

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PMID: 21068093

超聲檢查預(yù)測(cè)一年后RA病人的MRI侵蝕進(jìn)展

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Boyesen P, et al. Ann Rheum Dis. 2011;70: 176-9.

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目的: 探究在早期類風(fēng)濕關(guān)節(jié)炎(RA)患者中，基線時(shí)敏感影像學(xué)檢查的發(fā)現(xiàn)與隨訪一年后MRI侵蝕病變進(jìn)展之間的相關(guān)性。

方法: 病程小于1年的84例RA患者被納入這個(gè)起始隊(duì)列研究。病人評(píng)估時(shí)間點(diǎn)為基線、3個(gè)月、6個(gè)月和12個(gè)月。重要檢查包括疾病活動(dòng)性、MRI和灰階超聲 (USGS)評(píng)估炎癥、傳統(tǒng)放射學(xué)平片、數(shù)字X射線計(jì)量?jī)x(DXR)測(cè)量手皮質(zhì)骨骨密度(BMD)。

結(jié)果: 79例病人完成隨訪，其中有53(67%)出現(xiàn)MRI證實(shí)的侵蝕進(jìn)展(因變量)。多變量分析發(fā)現(xiàn)USGS和MRI證實(shí)的骨髓水腫(BME)是1年后MRI侵蝕病變進(jìn)展的獨(dú)立預(yù)測(cè)因素。有一個(gè)趨勢(shì)顯示MRI侵蝕患者的MRI滑膜炎評(píng)分較高，而且3個(gè)月時(shí)DXR-BMD下降。在個(gè)體水平，USGS炎癥、MRI滑膜炎和MRI骨髓水腫也較類風(fēng)濕因子、抗CCP抗體以及DAS28更好地預(yù)測(cè)結(jié)局。

結(jié)論: 在組水平的分析發(fā)現(xiàn)，USGS炎癥和MRI骨髓水腫是早期RA病人MRI侵蝕進(jìn)展的獨(dú)立預(yù)測(cè)因素。但是單憑影像學(xué)并不能準(zhǔn)確判斷每個(gè)病人的預(yù)后。