磁共振成像联合抗环瓜氨酸肽抗体对早期类风湿关节炎的诊断价值

The diagnostic value of magnetic resonance imaging combined with anti-cyclic citrullinated peptide antibody in early rheumatoid arthritis

目的结合血清抗环瓜氨酸肽(CCP)抗体的水平研究磁共振成像(MRI)对类风湿关节炎(RA)手关节病变的诊断价值。方法收集符合多关节肿痛患者83例,男12例,女71例,行双手及双腕关节MRI扫描,均采用自旋回波(SE)、短时反转恢复(STIR)序列。采用酶联免疫吸附试验(ELISA)测定患者血清抗CCP抗体的水平。结果初诊及随诊中病情进展达到美国风湿病学会(ACR)RA诊断标准可确诊的患者69例,其中抗CCP抗体阳性者51例,阳性率为74%。43例RA患者MRI显示滑膜炎,其中,滑膜炎组38例有骨髓水肿,29例有骨质破坏。结论 MRI扫描结合抗CCP抗体检测有助于RA的早期诊断。

Objective To investigate the diagnostic value of magnetic resonance imaging （MRI） combined with anti-cyclic citrullinated peptide （CCP） antibody for early rheumatoid arthritis（RA）. Methods Eighty-three patients with polyarthritis（male： n=12, female： n=71） underwent MR scanning of the hands and wrists. All MR imaging was performed using spin echo （SE） and short time inversion recovery （STIR） sequences. Anti-CCP serum levels of patients were determined by ELISA. Results During the first visit and the regular checkups, 69 patients met the diagnostic criteria of ACR and were confirmed with RA. Notably, 51 patients （74%） with positive anti-CCP antibody. MRI showed 43 RA patients with synovitis. Notably, there were 38 cases of bone marrow edema and 29 cases of bone destruction in the synovitis group. Conclusion MRI scanning combined with detection of anti-CCP antibody may be helpful in the early diagnosis of RA.