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
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
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DOI：
10.1002/art.1780401020
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发表时间：
1997-10-01
影响因子：
--
通讯作者：
Lorenzen, IB
中科院分区：
文献类型：
--
作者：
Ostergaard, M;Stoltenberg, M;Lorenzen, IB
Objective.目的探讨类风湿性关节炎（RA）和骨关节炎（OA）患者滑膜和关节积液量与磁共振成像（MRI）及滑膜大体和镜下病理改变的关系。对17例RA和25例OA膝关节进行关节镜检查或关节切开术时，在预先选定的膝关节部位进行滑膜活检，并对滑膜炎进行肉眼分级。对滑膜炎症和9种单独的组织特征进行组织学分级。术前通过MRI确定滑膜和关节积液量，并通过静脉注射钆喷酸二甲胺进行增强。MRI确定的滑膜体积与滑膜炎症的总体组织学评估相关（斯皮尔曼σ = 0.55，P < 0.001），伴有纤维蛋白沉积，滑膜下单核细胞和多形核白细胞浸润（σ = 0.51-0.59），肉眼可见滑膜炎、血管增生和肉芽组织形成不太显著与滑膜衬里增生、血管周围水肿、绒毛形成、纤维化无相关性（σ < 0.30）。MRI测定的滑膜体积与滑膜炎性活动相关，滑膜体积可能主要反映滑膜下细胞浸润、血管化组织的质量，但也可能受到累积滑膜增殖活动的影响，MRT测定的滑膜和积液体积可能是RA疾病活动和治疗结果的敏感指标和/或预测因子。
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).Conclusions. 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, MRT-determined synovial membrane and effusion volumes may be sensitive makers and/or predictors of disease activity and treatment outcome in RA.