不同MRI技术对类风湿性关节炎活动度的诊断价值  

Diagnostic Value of Different MRI Techniques for Disease Activity in Patients with Rheumatoid Arthritis

作　　者：刘婷[1] 夏上[1] LIU Ting;XIA Shang(Department of Rhematology,Crntral South Hospital of Wuhan University,Wuhan 430071,Hubei Province,China)

机构地区：[1]武汉大学中南医院风湿免疫科,湖北武汉430071

出　　处：《中国CT和MRI杂志》2020年第9期172-174,共3页Chinese Journal of CT and MRI

摘　　要：目的分析不同MRI技术对类风湿性关节炎(rheumatoid arthritis,RA)活动度的诊断价值。方法将2014年1月至2018年8月在我院确诊为RA的126例患者参照DAS-28评分结果分为临床缓解组(n=42)、中度活动组(n=48)、高度活动组(n=36),对比其获DCE-MEI及DWI量化参数,并绘制ROC曲线明确其诊断效能。结果三组RA患者DCE-MRI影像相关指标EER、MER、AER、TTP比较差异均有统计学意义,且临床缓解组早期强化率(EER)、平均强化率(AER)、最大强化率(MER)<中度活动组<重度活动组,临床缓解组、达峰时间(TTP)、ADC值>中度活动组>重度活动组,差异有统计学意义;EER、MER、AER、TTP、ADC的AUC值分别为0.689、0.804、0.926、0.805、0.768,最佳敏感阀值依次为0.785、1.326、0.649、3.147、1.920,其中AER诊断RA活动度时效能最佳。结论 DCE-MRI、DWI用于诊断RA活动性均具一定临床价值,但前者或者取得更佳诊断获益,值得临床进一步深入探究。Objective To analyze the diagnostic value of different MRI techniques for the activity of rheumatoid arthritis (RA).Methods 126 patients diagnosed with RA in our hospital from January 2014 to August 2018 were divided into clinical remission group (n=42),moderate activity group (n=48),and high activity group (n=36) according to DAS-28 score,DCE-MEI and DWI quantitative parameters were copmpared between the three groups,the diagnostic efficacy was determined by the ROC curve.Results There were significant differences in Dce-mri related indicators such as EER,MER,AER and TTP between the three groups of RA patients.Ranking from low to high according to the rate of reinforcement such as the early enhancement rate (EER),average enhancement rate (AER) and maximum enhancement rate (MER),the order was the clinical remission group,moderate activity group and severe activity group.Ranking from more to less according to the peak time (TTP) and ADC value,the order was clinical remission group,moderate activity group and severe activity group;the AUG values of EER,MER,AER,TTP,ADC The values were 0.689,0.804,0.926,0.805,and 0.768,respectively,The optimal sensitivity thresholds were 0.785,1.326,0.649,3.147,and 1.920,respectively.Among them,AER was the best at diagnosing RA activity.

关 键 词：MRI 类风湿性关节炎 活动度 诊断价值 

分 类 号：R593.22[医药卫生—内科学] R445.2[医药卫生—临床医学]