Contrast-enhanced MRI compared with the physical examination in the evaluation of disease activity in juvenile idiopathic arthritis
Contrast-enhanced MRI compared with the physical examination in the evaluation of disease activity in juvenile idiopathic arthritis
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DOI：
10.1007/s00330-013-3036-2
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发表时间：
2014-02-01
影响因子：
5.9
通讯作者：
Kuijpers, Taco W.
中科院分区：
文献类型：
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作者：
Hemke, Robert;Maas, Mario;Kuijpers, Taco W.
为了评价磁共振成像（MRI）在区分活动期和非活动期幼年特发性关节炎（JIA）患者中的价值，并比较体格检查结果与MRI结果在评估JIA患者疾病状态中的作用，采用开孔MRI对有膝关节受累的连续性JIA患者进行前瞻性研究。分析了146例JIA患者的影像学表现（59.6%为女性，平均年龄12.9岁）。将患者分类为临床活跃或非活跃。使用JAMRIS系统评价MRI特征，包括滑膜肥大、骨髓水肿、软骨病变和骨侵蚀的有效评分。所有MRI特征的阅片者间可靠性良好（组内相关系数[ICC] = 0.87-0.94）。两组间骨髓水肿、软骨病变或骨侵蚀的MRI评分无差异。两组之间的滑膜肥大评分差异显著（P = 0.016）。尽管如此，滑膜肥大也存在于14例（35.9%）临床非活动性疾病的JIA患者中。在临床活跃的JIA患者中，48.6%的患者没有表现出基于MRI的滑膜炎体征。MRI可以区分临床活跃和非活跃的JIA患者。然而，体格检查在评估JIA疾病活动性方面既不敏感也不特异。亚临床滑膜炎存在于> 35%的假定临床非活动期患者中。aEuro cent MRI对评估幼年特发性关节炎（JIA）疾病活动性是敏感的。aEuro cent对比增强MRI可以区分临床活动期和非活动期JIA患者。aEuro cent亚临床滑膜炎存在于35.9%结论：欧洲体格检查对判断JIA病的活动性既不敏感也不特异。
To assess the value of magnetic resonance imaging (MRI) in discriminating between active and inactive juvenile idiopathic arthritis (JIA) patients and to compare physical examination outcomes with MRI outcomes in the assessment of disease status in JIA patients.Consecutive JIA patients with knee involvement were prospectively studied using an open-bore MRI. Imaging findings from 146 JIA patients were analysed (59.6 % female; mean age, 12.9 years). Patients were classified as clinically active or inactive. MRI features were evaluated using the JAMRIS system, comprising validated scores for synovial hypertrophy, bone marrow oedema, cartilage lesions and bone erosions.Inter-reader reliability was good for all MRI features (intra-class correlation coefficient [ICC] = 0.87-0.94). No differences were found between the two groups regarding MRI scores of bone marrow oedema, cartilage lesions or bone erosions. Synovial hypertrophy scores differed significantly between groups (P = 0.016). Nonetheless, synovial hypertrophy was also present in 14 JIA patients (35.9 %) with clinically inactive disease. Of JIA patients considered clinically active, 48.6 % showed no signs of MRI-based synovitis.MRI can discriminate between clinically active and inactive JIA patients. However, physical examination is neither very sensitive nor specific in evaluating JIA disease activity compared with MRI. Subclinical synovitis was present in > 35 % of presumed clinically inactive patients.aEuro cent MRI is sensitive for evaluating juvenile idiopathic arthritis (JIA) disease activity.aEuro cent Contrast-enhanced MRI can distinguish clinically active and inactive JIA patients.aEuro cent Subclinical synovitis is present in 35.9 % of presumed clinically inactive patients.aEuro cent Physical examination is neither sensitive nor specific in evaluating JIA disease activity.