影像学诊断在类风湿关节炎患者中的应用研究  

Research on application of imaging diagnosis in rheumatoid arthritis

作　　者：刘卫宾 刘海平[1] 

机构地区：[1]河北省保定市第二中心医院放射科,072750

出　　处：《检验医学与临床》2015年第18期2731-2733,共3页Laboratory Medicine and Clinic

摘　　要：目的研究MRI、CT等影像学诊断在类风湿关节炎患者诊断、治疗及预后评估中的应用情况。方法选取70例类风湿关节炎患者,收集患者的临床资料,对相关抗体、炎性反应指标进行检查,评价疾病活动情况,同时实施MRI、SPECT/CT等影像学检查,对MRI图像按RAMRIS系统评分,对骨代谢增加区域行感兴趣区(ROI)分析计算摄取率,并就相关数据进行统计学分析。结果 SDAI与RAMRIS的Spearman相关性:滑膜炎(ρ=0.391,P<0.05),骨髓水肿(ρ=0.402,P<0.05),侵蚀(ρ=0.329,P=0.006)。在SDAI<11(低疾病活动度和缓解患者)和SDAI≥11(中、重度疾病活动患者)组间RAMRIS评分有差异(P=0.002)。但在低疾病活动和缓解患者之间,中度和重度活动患者之间MRI评分差异无统计学意义。SPECT/CT摄取率与患者体内炎性因子ESR、CRP均有相关性,ESR(ρ=0.343,P<0.05),CRP(ρ=0.431,P<0.05);摄取率与抗炎因子AKA也明显相关(ρ=0.263,P<0.05)。此外,摄取率与疾病活动程度SDAI也明显相关(ρ=0.355,P<0.05)。结论 MRI、CT等影像学方法有助于早期诊断类风湿关节炎,MRI以及SPECT/CT的摄取率对评价类风湿关节炎进展、预后都有积极意义。Objective To investigate the application situation of imaging diagnosis of MRI ,CT ,etc .in rheumatoid arthritis（RA） .Methods 70 patients with RA in our hospital were selected and their clinical data were collected . The related antibodies and inflammatory reaction indicators were detected .The disease activity situation was assessed .At the same time the imaging examinations such as MRI and SPECT /CT were performed .The MRI images were scored according to the RAMRIS system .The bone metabolism increasing area was performed the region of interest （ROI） analysis for calculating the uptake ratio of ROI .Results The Spearman correlation of SDAI and RAMRIS ：synovitis （ρ = 0 .391 ,P〈 0 .05） ,bone marrow edema（BME） （ρ = 0 .402 ,P〈 0 .05） and erosion（ρ = 0 .329 ,P=0 .006） .The RAMRIS score had statistical difference between SDAI 〈 11 （low disease activity and remission） and SDAI ≥ 11 group（moderate and severe disease activity） （P= 0 .002） .The SPECT /CT in vivo uptake had the correlation with the body inflammatory factors of ESR and CRP （ρ = 0 .343 ,P〈 0 .05 ,ρ = 0 .431 ,P〈 0 .05） ;and the uptake was also significantly correlated with the antiinflammatory cytokine AKA （ρ = 0 .263 ,P〈 0 .05） .In addition ,the uptake rate was also significantly correlated with the disease activity SDAI（ρ = 0 .355 ,P〈 0 .05） .Conclusion The imaging methods of MRI and CT conduce to early diagnosis of RA and the uptake rate of MRI and SPECT /CT has positive significance to evaluate the progression and prognosis of RA .

关 键 词：类风湿关节炎 诊断 治疗 影像学方法 

分 类 号：R593.22[医药卫生—内科学]