动态增强MRI对判断类风湿关节炎活动性价值的研究

Dynamic contrast-enhanced MRI evaluate the activity in rheumatoid arthritis

目的:研究动态增强MRI对评价早期类风湿关节炎活动性方面的价值。方法:对10例活动期和13例静止期RA患者的滑膜滑膜强化率和滑膜厚度并采用秩和检验和t检验等方法进行统计学比较。计算每个患者的MRI评分(评分标准见表8),依据临床症状和实验室检查计算其DAS28评分。将每个患者的MRI评分、滑膜强化率及滑膜厚度分别与其DAS28评分采用相关性分析方法进行统计学比较。结果:①活动期RA组滑膜动态强化曲线呈快速上升平台型强化曲线,静止期RA滑膜动态强化曲线呈缓慢上升强化曲线。活动期与静止期滑膜强化率差别有统计学意义(Z值3.361,P值0.001);②活动期RA组滑膜厚度(3.7±0.4mm)和静止期RA组滑膜厚度(2.9±0.6mm)差别有统计学意义(T值3.025,P值0.002);③RA患者MRI评分(21.93±25.23)、滑膜强化率(98.51±59.35)及滑膜厚度(3.4mm±0.7mm)分别与DAS28评分(4.25±2.72)正相关(相关系数R值分别为0.801、0.668和0.038,P值分别为0.000、0.005和0.002)。结论:动态增强MRI和RA患者的MR总评分可以综合评价RA活动性程度和其所处的病理阶段。

Objective：To study the value of dynamic contrast-enhanced magnetic resonance imaging in evaluating the activity of early stage RA.Methods：Plain MRI,enhanced MRI of whole hand and dynamic contrast-enhanced MRI（DCE-MRI） of single slice were perfermed in 13 cases of actived RA and 10 cases of inactived RA patients.The contrast rate and volume of synovial membrane were compared among two groups using rank-sum test and and t-test.MRI score（RAMRIS） of RA and desease activity score 28（DAS28） were calculated.RAMRIS with DAS28,the contrast rate of synovial membrane with DAS28 and the synovial membrane volume with DAS28 were compared using correlation analysis.Results：① Dynamic contrast rate of actived RA group was significantly higher than that of inactived RA group（P0.005）;② There was statistical difference of the synovial membrane volume between the actived RA group and the inactived RA group（P0.005）;③ The RAMRIS,the dynamic contrast rate and the synovial membrane volume is positive correlation with the DAS28.Conclusion：Dynamic contrast-enhanced MRI and RAMRIS can provide useful information to evaluate the activity degree and the pathologic phase of RA.