类风湿关节炎患者骨髓水肿和骨侵蚀的MRI联合CT诊断情况及预后相关性

MRI Combined with CT Diagnosis of Bone Marrow Edema and Bone Erosion in Patients with Rheumatoid Arthritis and Its Correlation with Prognosis

目的探究类风湿关节炎(RA)患者骨髓水肿和骨侵蚀的MRI联合CT诊断情况及预后相关性。方法选取我院2016年5月-2018年5月我院经临床确诊的类风湿性患者59例,患者均于治疗前以及治疗后半年随访观察中行CT及MRI扫描,对两种检查方法下的RA骨髓水肿(BME)及骨侵蚀进行评分,并比较治疗前后各征象之间的评分差异以及与临床预后治疗效果的相关性。结果59例患者的治疗有效率为74.58%(44/59),无效率为25.43%(15/59)。MRI检查中治疗有效患者与治疗无效患者的骨髓水肿治疗前后评分差值比较具有统计学意义(t=4.194,P=0.000),治疗有效患者与治疗无效患者的骨侵蚀治疗前后评分差值比较不具有统计学意义(t=0.460,P=0.647);CT检查中治疗有效患者与治疗无效患者的治疗前后SENS总评分差值比较不具有统计学意义(t=1.003,P=0.320)。类风湿关节炎患者治疗效果与MRI骨髓水肿评分、MRI骨侵蚀评分、CT骨侵蚀评分、CT关节间隙狭窄评分及CTSENS总评分均具有相关性(P<0.05)。结论类风湿关节炎患者采用MRI联合CT可对患者骨髓水肿和骨侵蚀的破坏情况进行定量分析,能根据MRI、CT相关骨髓水肿和骨侵蚀评分进行预后效果评估。

Objective To explore the diagnostic status and prognostic correlation of bone marrow edema and bone erosion in patients with rheumatoid arthritis(RA).Methods 59 patients with rheumatoid disease from May 2016 to May 2018 were selected.All patients underwent CT and MRI scanning before and after treatment for half a year.The bone marrow edema(BME)and bone erosion of RA were scored under the two methods,and the difference of the scores between the signs before and after treatment and the correlation with clinical prognosis and therapeutic effect were compared.Results The effective rate was 74.58%(44/59)and the ineffective rate was 25.43%(15/59).The difference in score between the effective patients and the ineffective patients before and after the treatment of bone marrow edema in MRI examination was statistically significant(t=4.194,P=0.000).There was no statistically significant difference in bone erosion score between the effective patients and the ineffective patients before and after treatment(t=0.460,P=0.647).There was no significant difference in the total score of SENS between the effective and ineffective patients before and after treatment in CT examination(t=1.003,P=0.320).The therapeutic effect of rheumatoid arthritis patients was correlated with MRI bone marrow edema score,MRI bone erosion score,CT bone erosion score,CT joint space stenosis score and CT SENS total score(P<0.05).Conclusion MRI combined with CT can quantitatively analyze the damage of bone marrow edema and bone erosion in patients with rheumatoid arthritis,and evaluate the prognostic effect according to the scores of MRI,CT related bone marrow edema and bone erosion edema.