MR Imaging findings in hands in early rheumatoid arthritis: Comparison with those in systemic lupus erythematosus and primary Sjogren syndrome
MR Imaging findings in hands in early rheumatoid arthritis: Comparison with those in systemic lupus erythematosus and primary Sjogren syndrome
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DOI：
10.1148/radiol.2361040844
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发表时间：
2005-08-01
期刊：
影响因子：
19.7
通讯作者：
Cotten, A
中科院分区：
文献类型：
--
作者：
Boutry, N;Hachulla, E;Cotten, A
目得：前瞻性评价磁共振（MR）成像在手部炎性多关节痛患者中鉴别真性类风湿性关节炎（RA）与系统性红斑狼疮（SLE）或原发性干燥综合征的应用。但没有RA的放射学证据。材料和方法：本研究得到了机构审查委员会的批准，并获得了患者知情同意书。28例早期RA患者（16例女性和12例男性患者;平均年龄42岁）和19例SLE（n = 14）或原发性Sjogren综合征（n = 5）患者（18例女性和1例男性患者，平均年龄46岁）接受了双手MR成像。所有患者均有手部炎性多关节痛，X线片上无糜烂性改变的证据。获得冠状位T2加权短反转时间反转恢复、横向T1加权自旋回波、横向脂肪抑制钆增强T1加权自旋回波和横向钆增强三维梯度回波MR图像。评估腕关节和非拇指掌指关节的以下MR成像变量：滑膜炎、骨病变（侵蚀、缺损和水肿）和腱鞘炎。使用OMERACT RA-MRI评分系统对滑膜炎和骨病变进行评分。结果：两组在滑膜炎、骨损伤和腱鞘炎的个体评分方面的唯一显著差异是，非RA患者右侧第四伸肌肌腱腱鞘炎的发生率更高（P = 0.04）。在滑膜炎、骨病变和腱鞘炎的总体评分方面，RA患者与非RA患者之间无显著差异。结论：早期RA患者与非RA患者（即SLE或原发性干燥综合征患者）的MRI表现可能无法区分。(c)RSNA，2005年
PURPOSE: To evaluate prospectively the use of magnetic resonance (MR) imaging for differentiating true rheumatoid arthritis (RA) from systemic lupus erythematosus (SLE) or primary Sjogren syndrome in patients who have inflammatory polyarthralgia of the hands. but no radiographic evidence of RA.MATERIALS AND METHODS: This study had institutional review board approval, and patient informed consent was obtained. Twenty-eight patients (16 female and 12 male patients; mean age, 42 years) with early RA and 19 patients (18 female and one male patient, mean age, 46 years) with SLE (n = 14) or primary Sjogren syndrome (n = 5) underwent MR imaging of both hands. All patients had inflammatory polyarthralgia of the hands and no evidence of erosive changes on radiographs. Coronal T2-weighted short inversion time inversion-recovery, transverse T1-weighted spin-echo, transverse fat-suppressed gadolinium-enhanced T1-weighted spin-echo, and transverse gadolinium-enhanced three-dimensional gradient-echo MR images were obtained. The following MR imaging variables were assessed in the wrist and nonthumb metacarpophalangeal joints: synovitis, bone lesions (erosion, defect, and edema), and tenosynovitis. Synovitis and bone lesions were scored with the OMERACT RA-MRI scoring system. Findings in patients with RA and those without RA were compared by means of Mann-Whitney, chi(2), and Fisher exact tests.RESULTS: The only significant difference between the two groups in terms of individual scores for synovitis, bone lesions, and tenosynovitis was the more frequent presence of tenosynovitis of the right fourth extensor tendon in patients without RA (P = .04). There were no significant differences between patients with RA and those without RA in terms of global scores for synovitis, bone lesions, and tenosynovitis. However, bone marrow edema in the metacarpophalangeal joints was seen more frequently in patients with RA (P < .001).CONCLUSION: It may be impossible to distinguish between patients with early RA and those without RA (ie, those with SLE or primary Sjogren syndrome) by means of MR imaging. (c) RSNA, 2005