摘要
目的探讨MRI和CT影像学方法在类风湿性关节炎(RA)患者临床诊断、治疗及预后评估中的作用。方法选取本院2013年7月至2014年7月收治的120例RA患者作为研究对象,回顾性分析其临床资料,将3个月≤病程≤1年的早期RA关节肿痛患者分为ERA组(55例),而确诊为RA的患者为RA组(65例),两组患者均符合RA分类标准,完成了MRI、CT等影像学检查,对MRI的图像按照类风湿核磁共振成像评分系统(RAMRIS)进行评分,对骨代谢的增加区进行感兴趣区(ROI)分析并计算其摄取率,并对其缓解情况进行跟踪随访,分析其影像学资料。结果 12个月后,ERA组的缓解率达80.0%,RA组为56.9%;18个月后,ERA组的缓解率达96.3%,RA组为70.8%。RA组的侵蚀发生率明显高于ERS组,差异具有统计学意义(P<0.05)。单侧MRI与双侧MRI的评分线性关系较好(滑膜炎:ρ=0.98;BME:ρ=0.91;侵蚀:ρ=0.91)。正常的关节区标记物的摄取率明显低于病变的关节区域,差异具有统计学意义(P<0.05)。结论采用MRI、CT等影像学方法可进行RA的早期诊断,单侧手腕的MRI评价可用于评估临床疾病活动,CT用于检测RA关节炎炎症中的骨代谢情况具有较高的敏感性,因此MRI和CT的摄取率对于评价疾病的进展具有较大的临床意义。
Objective To explore the clinical application value of MRI and CT in diagnosis, treatment and prognosis assessment of patients with rheumatoid arthritis（RA）. Methods 120 cases of RA patients admitted to our hospital from July 2013 to July 2014 were selected as research objects, and the clinical data were analyzed retrospectively. All patients were divided into two groups： 55 cases of early RA with articular pain were set as the ERA group, while 65 cases of established RA patients were set as RA group. Imagines such as MRI and CT were performed in all cases and MRI images were scored by the RAMRIS system. Bone metabolism increased was analyzed by calculation of uptake ratio of the regional area of interest（ROI）. All cases were follow-up to know the remission situation. Results The remission rates of ERA group and RA group were 80.0% and 56.9% respectively at 12 thmonth, and 96.3% and 70.8% respectively at 18 th month. The incidence of bone erosion of RA group was significantly higher than that of ERA group（P 0.05）. The linear relationships between single side MRI and double side MRI were good（synovitis： ρ = 0.98; BME： ρ = 0.91; erosion： ρ = 0.91）. The uptake rate of markers of normal joint area was significantly lower than that of pathological joint area, and the difference was statistically significant（P 0.05）.Conclusions MRI and CT imaging can be used for early diagnosis of RA. Unilateral hand MRI evaluation is suitable in assessment of the disease activity. CT is sensitive in detecting the bone metabolism changes. The uptake ratio of MR and CT is meaningful to evaluate the disease progression.
出处
《临床医学工程》
2016年第1期1-3,共3页
Clinical Medicine & Engineering
关键词
类风湿性关节炎
诊断
治疗
预后评估
核磁共振
CT
Rheumatoid arthritis
Diagnosis
Treatment
Prognosis assessment
Magnetic resonance imaging
CT
