腕部MRI体积定量分析评价类风湿关节炎疗效

MRI volume quantitative analysis in evaluation on therapeutic effect of wrist rheumatoid arthritis

目的探讨腕部MRI体积定量分析对于评价类风湿关节炎(RA)疗效的价值。方法收集30例活动期RA并接受规律治疗1年患者,应用MRI体积定量分析软件测量治疗前后同一腕关节滑膜炎、骨髓水肿体积,并获取同期患者红细胞沉降率(ESR)和C反应蛋白(CRP),计算28关节疾病活动度(DAS28)。分析治疗前后滑膜炎、骨髓水肿、CRP、ESR、DAS28变化,并将滑膜炎、骨髓水肿变化量与CRP、ESR、DAS28变化量进行相关性分析。结果治疗后滑膜炎体积、骨髓水肿范围、CRP、ESR、DAS28均显著降低(P均<0.05)。滑膜炎与骨髓水肿变化量呈正相关(r=0.61,P<0.01)。滑膜炎、骨髓水肿变化量与ESR、CRP变化量均无明显相关(P均>0.05),滑膜炎、骨髓水肿变化量均与DAS28变化量呈正相关(r=0.50、0.56,P=0.01、<0.01)。结论MRI定量分析可作为量化指标,准确客观监测RA病情和评价疗效。

Objective To explore the application value of MRI quantitative analysis in evaluation on therapeutic effect of rheumatoid arthritis(RA)of the wrist.Methods Totally 30 patients with RA after regular treatment for 1 year were enrolled.The wrist joint was scanned before and after treatment,and the volume of synovitis and bone marrow edema before and after treatment were measured by using the quantitative analysis software.The erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and disease activity score of 28(DAS28)were also obtained.Changes of synovitis,bone marrow edema,CRP,ESR and DAS28 were analyzed before and after treatment,correlation analysis was performed on the changes of synovitis and bone marrow edema with changes of CRP,ESR and DAS28.Results After treatment,the volume of synovitis,the range of bone marrow edema,CRP,ESR and DAS28 of the patients reduced significantly(all P<0.05).Synovitis was strongly correlated with changes in bone marrow edema(r=0.61,P<0.01).Changes in synovitis and bone marrow edema were not significantly correlated with those of ESR and CRP(all P>0.05),while changes in synovitis and bone marrow edema were moderately correlated with changes of DAS28(r=0.50,0.56,P=0.01,<0.01).Conclusion MRI quantitative analysis can be used as accurate and objective quantitative indices for monitoring and evaluating therapeutic effect of RA.