学术论文

      动态增强MRI对手部类风湿性关节炎活动性的诊断价值

      The diagnostic value of dynamic contrast-enhanced MRI in the activity of rheumatoid arthritis lesions of hand

      摘要:
      目的:研究动态增强磁共振扫描(DCE-MRI)对类风湿性关节炎(RA)患者活动性评价价值,为其早期治疗方案合理制定提供可靠依据.方法:对经临床诊断32例RA患者手部及腕关节DCE-MRI时间强度曲线、血流动力学参数及其临床活动性评分(DAS28)进行分析总结.根据临床疾病活动与否进行分组,比较组间血流动力学参数相对强化率(RE)、早期强化率(REE)有无差异性.结果:①RA活动组滑膜动态强化曲线呈速升平台型或速升缓升型.RA缓解组滑膜动态强化曲线呈缓升平台型.②RA活动组、缓解组及对照组3组间RE、REE差异均有统计学意义(P值<0.05).③RA活动组滑膜REE、RE分别与DAS28评分呈正相关.结论:动态增强MR血流动力学指标可反应RA活动性.类风湿性关节炎MR征象可提示RA病变进展程度.
      Abstract:
      Objective:To investigate the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in evaluating the activity of rheumatoid arthritis(RA) on early stage.To provide a reliable basis for the reasonable development of RA treatment programs.Methods:The data of wrist DCE-MRI were reviewed in 32 cases of clinically diagnosed RA patients.The differences of the value of hemodynamic parameters,including relative enhancement ratio (RE),early enhancement ratio (REE),were compared in the patients with different activity.Results:(①The RA active group synovial dynamic enhancement curves were rapidly ascending and then reached a stable value.The TIC of remission group showed a slow rise.②The difference of synovial REE and the RE of the three groups was statistically significant.③In active RA group,REE and RE was positive correlation with DAS28.Conclusion:The DCE-MRI can provide useful information to evaluate the activity degree and the pathology phase of RA through hemodynamic parameters such as REE and RE.DCE-MRI of RA patients can provide comprehensive evaluation of the progression of RA.
      作者: 孙雁 张炳 季涛
      Author: SUN Yan ZHANG Bing JI Tao
      作者单位: 青岛市市立医院放射科,山东青岛,266000
      刊 名: 中国临床医学影像杂志 ISTICPKU
      年,卷(期): 2017, 28(3)
      分类号: R593.22 R445.2
      在线出版日期: 2017年4月12日