Comparison of low-field dedicated extremity magnetic resonance imaging with articular ultrasonography in patients with rheumatoid arthritis
Comparison of low-field dedicated extremity magnetic resonance imaging with articular ultrasonography in patients with rheumatoid arthritis
复制标题
类风湿性关节炎患者低场专用四肢磁共振成像与关节超声检查的比较
DOI：
10.1007/s10165-010-0318-2
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发表时间：
2011
期刊：
影响因子：
2.2
通讯作者：
et al.
中科院分区：
文献类型：
--
作者：
Horikoshi M;Suzuki T;Ikeda K;et al.
为比较磁共振成像（MRI）和超声（US）对类风湿关节炎（RA）关节炎性病变的诊断价值，对6例RA患者进行了US和低场0.3T非增强专用肢体MRI检查。所有患者均为女性，平均年龄为50.2岁，平均病程为13.5年，平均疾病活动评分（DAS）28-CRP为1.78。每例患者接受英夫利西单抗、依那西普、阿达木单抗或托珠单抗治疗。通过MRI评估腕骨间关节、桡尺关节、第二至第五近端指间关节（PIP）和第一至第五掌指关节（MCP）（共132个关节，每例患者22个关节）是否存在关节炎症。共156个关节（24个第一指间关节和桡腕关节加上上述132个关节），由两名受过培训的超声医师通过灰阶超声（GS-US）和能量多普勒超声（PD-US）评估关节炎症的存在。我们评估了MRI和GS-US/PD-US上关节炎症之间的相关性，以及通过计算组内相关系数（ICC）评估了两名超声检查者之间的相关性。GS-US在74/156个关节中检测到滑膜肥大和/或滑液，PD-US在10/156个关节中检测到滑膜炎，MRI在38/132个关节中检测到滑膜炎。以PD-US为参照，MRI对滑膜炎的诊断敏感性为80%。以MRI为参考，PD-US的敏感性为21%。PD-US的特异性高于MRI。GS-US和MRI之间以及PD-US和MRI之间的总体一致性分别为0.56和0.76，表明PD-US的结果与MRI的结果接近。GS-US和PD-US的ICC分别为0.545和0.807，表明PD-US在检测关节炎症方面具有特异性。我们的研究结果表明，PD-US的结果与MRI的结果相关。低场MRI和PD-US是评估RA患者的有用工具。
To compare magnetic resonance imaging (MRI) and ultrasonography (US) in the detection of joint inflammation of rheumatoid arthritis (RA), 6 patients with RA were examined by US and low-field 0.3-T nonenhanced dedicated extremity MRI (compacTscan). All patients were females, with mean age of 50.2 years, mean disease duration of 13.5 years, and mean disease activity score (DAS)28-CRP of 1.78. Each patient was treated with either infliximab, etanercept, adalimumab, or tocilizumab. Intercarpal joints, radioulnar joints, second through fifth proximal interphalangeal (PIP) joints, and first through fifth metacarpophalangeal (MCP) joints (a total of 132 joints, 22 joints in each patient) were assessed by MRI for presence of joint inflammation. A total of 156 joints (24 first interphalangeal and radiocarpal joints plus the above 132 joints), were assessed by grayscale US (GS-US) and power Doppler US (PD-US) for presence of joint inflammation by two trained ultrasonographers. We assessed correlations between joint inflammations on MRI and GS-US/PD-US, and also interobserver correlation between the two ultrasonographers by calculating intraclass correlation coefficients (ICC). Synovial hypertrophy and/or synovial fluid was detected in 74/156 joints on GS-US, and synovitis was detected in 10/156 joints on PD-US and in 38/132 joints on MRI. Using PD-US as a reference, sensitivity of MRI in detection of synovitis was 80%. Using MRI as a reference, sensitivity of PD-US was 21%. Specificity of PD-US was higher than that of MRI. Overall agreement between GS-US and MRI and between PD-US and MRI was 0.56 and 0.76, respectively, suggesting that results of PD-US are close to those of MRI. ICC was 0.545 for GS-US and 0.807 for PD-US, suggesting specificity of PD-US in detecting joint inflammation. Our results show that findings of PD-US correlated with those of MRI. Low-field MRI and PD-US are useful tools for assessment of patients with RA.