MRI定量分析评价类风湿性关节炎疗效的初步临床应用  

Clinical value of assessing the therapy effect of rheumatoid arthritis using MRI scoring system

作　　者：夏鹏[1] 王德杭[1] 蒋兆贯[2] 陶娟 顾光官[2] 冯阳[1] 吴斌龙 

机构地区：[1]南京医科大学第一临床医学院放射科,江苏南京210029 [2]江苏省无锡市中医医院放射科 [3]江苏省无锡中医医院风湿科,江苏无锡214001

出　　处：《中国CT和MRI杂志》2011年第4期55-58,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨MRI评分评价类风湿性关节炎(rheumatoid arthritis,RA)疗效的临床价值。方法对临床确诊的59例RA患者双腕关节及双手分别于治疗前及疗程结束后进行MRI成像,分析治疗前后MRI图像,根据OMERACT RAMRIS评分系统分别进行评分并记录。根据临床资料对病人的疗效进行判断。分析MRI评分、MR征象与临床相关活动性指标及临床疗效的相关性。结果骨髓水肿评分与ESR间有相关性(r=0.278,P=0.033);MRI征象总评分与ESR(r=0.272,P=0.037)和CRP(r=0.279,P=0.033)有相关性。在治疗有效和无效的病人中,治疗后MRI总评分变化值有差异(15.8±9.8vs5.3±13.3,Mann-Whitney Test,P<0.001)。ROC曲线分析结果显示,以治疗后总评分差值≥10.5分为诊断治疗有效的标准,敏感度为81%,特异度为71.1%。结论 MRI评分可反映RA的活动性和评价临床疗效,具有一定的临床应用价值。Objective to investigate the clinical values of assessing the therapy effect of rheumatoid arthritis using MR/scoring system. Materials and methods MR images of both wrists and the 2rid to 5th metacarpophalangeal joints of 59 patients with RA were analyzed. MR/scores of each patient were acquired using OMERACT RAMRIS Scoring System. The relationships between MR/score of each sign, between MR/score and clinical data were analyzed respectively. Results There were significant correlation between bone edema score and ESR（r=0.278, P=0.033）, MRI total score and ESR（r=0.272, P=0.037）, MRI total score and CRP（r=0.279, P=0.033）. There was a significant difference of MRI total score changes after therapy between response and non-response group （15.8±9.8 vs 5.3±13.3, Mann-Whitney Test （P〈0.001）. The results of ROC analysis for identification of respond- ing lesions showed that threshold MR/total score changes after therapy of 10.5 had 81% sensitivity and 71.1% specificity. Conclusion the MRI scoring system can be used to assess the activity of RA and evaluate the therapy effect in clinical study.

关 键 词：关节炎 风湿性 腕关节 磁共振成像 疗效评价 

分 类 号：R593.21[医药卫生—内科学] R445.2[医药卫生—临床医学]