药物治疗前后RA患者DCE-MRI参数变化及对骨侵蚀情况的影响

Changes of DCE-MRI Parameters in RA Patients Before and After Drug Treatment and Its Effect on Bone Erosion

本文探究类风湿关节炎(RA)药物治疗前后动态增强磁共振成像(DCE-MRI)定量参数变化及对骨侵蚀情况的影响。选取112例RA患者,于药物治疗前后行DCE-MRI检查测量定量参数[最大增强(Emax)、最大相对增强(REmax)、相对增强(RE)、最大强化斜率(Slopemax)],比较有反应和无反应患者治疗前后DCE-MRI定量参数、骨侵蚀评分。结果显示,无反应者治疗前、治疗后Emax、REmax、RE、Slopemax均高于有反应者,治疗前后Emax、REmax、RE、Slopemax变化值均低于有反应者(P<0.05)。治疗前后Emax、REmax、RE、Slopemax变化值均与RA患者药物治疗反应性呈正相关(P<0.05)。治疗前Emax、REmax、RE、Slopemax联合预测RA药物治疗反应性为无反应的曲线下面积(AUC)为0.901(95%CI:0.830~0.949)。无反应者治疗前、治疗后骨侵蚀评分均高于有反应者,治疗前后骨侵蚀评分变化值低于有反应者(P<0.05)。治疗前后Emax、REmax、RE、Slopemax变化值均与RA患者骨侵蚀评分变化值呈正相关(P<0.05)。可见,治疗前DCE-MRI定量参数Emax、REmax、RE、Slopemax能预测RA药物治疗反应性,且各参数变化值与骨侵蚀变化情况密切相关。

This paper investigated the changes in quantitative parameters of dynamic enhanced magnetic resonance imaging(DCE-MRI)before and after drug treatment for rheumatoid arthritis(RA)and the effects on bone erosion.112 patients with RA were selected,and quantitative parameters[maximum enhancement(Emax),maximum relative enhancement(REmax),relative enhancement(RE),and slope of maximum enhancement(Slopemax)]were measured by DCE-MRI before and after drug treatment to compare quantitative DCE-MRI parameters and bone erosion scores before and after treatment in patients with and without response.The results showed that Emax,REmax,RE,and Slopemax in non-responders were higher than in responders before and after treatment,and the change values of Emax,REmax,RE,and Slopemax before and after treatment were lower than those of responders(P<0.05).The change values of Emax,REmax,RE,and Slopemax before and after treatment were positively correlated with drug treatment in RA patients(P<0.05).The area under the curve(AUC)of the combination of Emax,REmax,RE,and Slopemax before treatment to predict RA drug treatment responsiveness as non-response was 0.901(95%CI:0.830-0.949).The bone erosion scores before and after treatment in non-responders were higher than in responders,and the change in bone erosion scores before and after treatment was lower than in responders(P<0.05).The values of Emax,REmax,RE,and Slopemax before and after treatment were positively correlated with the change in bone erosion score in RA patients(P<0.05).It can be seen that the quantitative parameters Emax,REmax,RE,and Slopemax of DCE-MRI before treatment can predict the responsiveness to RA drug treatment,and the change values of each parameter are closely related to the change of bone erosion.