Dynamic contrast enhanced MRI of bone marrow oedema in rheumatoid arthritis
Dynamic contrast enhanced MRI of bone marrow oedema in rheumatoid arthritis
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DOI：
10.1136/ard.2007.077271
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发表时间：
2008-02-01
影响因子：
27.4
通讯作者：
Moots, R.
中科院分区：
文献类型：
--
作者：
Hodgson, R.;Grainger, A.;Moots, R.
目的：本工作的目的是评估使用动态对比增强 (DCE) MRI 治疗骨髓水肿的可行性，将其与传统骨髓水肿评分系统进行比较，并确定抗肿瘤坏死因子 (TNF)α 治疗的效果。 方法：对 25 例类风湿性关节炎患者的腕关节和掌指关节进行研究。总共 14 例在抗 TNF α 治疗前和治疗后 1-2 周进行了成像。收集 T2 加权脂肪抑制图像。在静脉注射基于钆的造影剂之前、期间和之后采集了一系列动态的 24 个 3D 破坏梯度回波图像。使用传统的类风湿性关节炎 MRI 评分 (RAMRIS) 系统根据 T2 加权图像对水肿进行评分。使用水肿骨、邻近水肿骨和未受累骨的动态系列计算相对增强率（RER）。结果：总共56%的患者表现出骨髓水肿。骨髓水肿区域及其附近的 RER 显着增加。治疗后 RER 显着降低，但 RAMRIS 评分没有显着降低。结论：骨髓水肿的动态对比增强 MRI 为 RAMRIS 评分提供了额外的信息，并且可能是炎症活动和治疗反应的更敏感标记。
Aims: The aim of this work was to assess the feasibility of using dynamic contrast enhanced (DCE) MRI of bone marrow oedema, to compare it with conventional marrow oedema scoring systems, and to determine the effects of anti-tumour necrosis factor (TNF)alpha therapy.Methods: The wrist and metacarpophalangeal (MCP) joints of 25 patients with rheumatoid arthritis were studied. A total of 14 were imaged before and 1 - 2 weeks after anti-TNF alpha therapy. T2-weighted fat-suppressed images were collected. A dynamic series of 24 3D spoiled gradient-echo images were acquired before, during and after the intravenous administration of gadolinium- based contrast medium. Oedema was scored using the conventional Rheumatoid Arthritis MRI Scoring (RAMRIS) system from T2-weighted images. The relative enhancement rate (RER) was calculated using the dynamic series from oedematous bone, bone adjacent to oedema and from an uninvolved bone.Results: A total of 56% of patients showed bone marrow oedema. The RER was significantly increased in and adjacent to areas of marrow oedema. There was a significant reduction in the RER after treatment, but not in the RAMRIS score.Conclusions: Dynamic contrast enhanced MRI of bone marrow oedema yields additional information to RAMRIS scoring and may be a more sensitive marker of inflammatory activity and response to treatment.