Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals a high prevalence of erosions at four months after symptom onset
Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals a high prevalence of erosions at four months after symptom onset
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DOI：
10.1136/ard.57.6.350
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发表时间：
1998-06-01
影响因子：
27.4
通讯作者：
McLean, L
中科院分区：
文献类型：
--
作者：
McQueen, FM;Stewart, N;McLean, L
目的探讨腕部磁共振成像（MRI）在类风湿关节炎（RA）患者早期关节损伤诊断中的作用。方法：对42例早期RA患者（中位症状持续时间为4个月）进行mri检查。扫描分别由两名肌肉骨骼放射科医生使用新设计的评分系统进行评分，该评分系统经过验证。比较MRI表现、临床测量和HLA-DRB*01/04基因分型。结果：整体MRI评分的观察者间信度很高（r = 0.81），观察者内信度也很高（观察者1的r = 0.94，观察者2的r = 0.81）。滑膜炎评分差异较大（观察者间信度：r = 0.74）。45%的扫描（19 / 42）检测到糜烂，而x线平片检测到糜烂的比例为15%。最常见的糜烂部位是头状关节（39%），滑膜炎发生在桡腕关节尺侧，肌腱炎发生在尺侧腕伸肌腱。MRI总评分和MRI滑膜炎评分与C反应蛋白相关性最显著(r分别为0.40和0.42,p
Objectives-To evaluate the role of magnetic resonance imaging (MRI) of the wrist in detecting early joint damage in patients with rheumatoid arthritis (RA). Methods-MRI was performed on 42 patients with early RA (median symptom duration of four months). Scans were scored separately by two musculoskeletal radiologists using a newly devised scoring system, which was validated. MRI findings were compared with plain radiography, clinical measures, and HLA-DRB*01/04 genotyping.Results-Interobserver reliability for the overall MRI score was high (r = 0.81) as was intraobserver reliability (r = 0.94 for observer 1 and 0.81 for observer 2). There was more variation in scoring synovitis (interobserver reliability: r = 0.74). Erosions were detected in 45% of scans (19 of 42), compared with 15% of plain radiographs. The most common site for erosions was the capitate (39%), for synovitis the ulnar aspect of the radiocarpal joint, and for tendonitis, the extensor carpi ulnaris tendon. The total MRI score and MRI synovitis score correlated most significantly with C reactive protein (r = 0.40 and 0.42 respectively, p