摘要
目的探讨3.0TMRI动态增强技术对活动性类风湿性关节炎患者治疗效果判断的应用价值。方法选取48例治疗前DAS28评分≥3.2分的中高度活动性的RA患者,在接受正规治疗前及治疗后6个月分别行病变较重的单侧腕关节MRI平扫加动态增强扫描及图像后处理分析,分别选取目标腕关节周围滑膜异常强化区域6个感兴趣区,自动生成时间-信号TIC曲线,描述曲线形态并计算第4个时相的早期强化率;计算并记录入组患者治疗前、后DAS28评分分值。将患者治疗前、后DAS28评分分别与所测第4个时相的早期强化率进行Pearson相关性分析;对患者治疗前、后DAS28评分及第4个时相的早期强化率分别进行统计学分析,采用配对样本T检验,以P<0.05认为差异具有统计学意义。结果治疗前患者MR腕关节动态增强滑膜感兴趣区TIC曲线为速升平台型或速升缓升型,治疗后曲线为缓升型或近似基线型。患者治疗前、后第4个时相的早期强化率分别为(136.4±5.6%,42.6±12.4%),差异具有统计学意义(P<0.05,t值为4.527);治疗前、后DAS28评分(5.36±0.67)分,(2.77±0.45)分,差异具有统计学意义(P<0.05,t值为2.337)。治疗前后DAS28评分与治疗前、后第4个时相的早期强化率呈正相关,相关系数r值分别为(0.744和0.806;P值为0.01)。结论MR动态增强TIC曲线的形状、早期强化率对活动性RA患者治疗效果的判断具有较高价值。
Objective To explore the value of 3.0 T dynamic contrast-enhanced magnetic resonance imaging in judging the therapeutic effect of patients with active rheumatoid arthritis.Methods Forty-eight patients with moderately and highly active RA whose DAS28 score was more than or equal to 3.2 before treatment were selected.Unilateral wrist joint MR plain scan,dynamic contrast-enhanced scan and image post-processing analysis were performed before and 6 months after treatment.Six regions of interest of abnormal enhancement of synovium around the wrist joint were selected to generate time-signal TIC curve automatically,to describe the shape of the curve and to measure the early enhancement rate of the fourth phase.The DAS28 scores before and after treatment were calculated and recorded.Pearson correlation analysis was made between DAS28 score and the early enhancement rate of the fourth phase before and after treatment,and statistical analysis was made on the early enhancement rate of the fourth phase before and after treatment,and paired sample T test was used to test the difference with P<0.05.Results Before treatment,the TIC curve of dynamic enhanced synovial region of interest in patients with MR wrist joint was of fast-rising platform type or slow-rising type.After treatment,the TIC curve was of slow-rising type or approximate baseline type.The early enhancement rates of patients in the fourth phase before and after treatment were(136.4±5.6)%and(42.6±12.4)%respectively.The difference was statistically significant(P<0.05,t value was 4.527).The DAS28 scores before and after treatment were(5.36±0.67,2.77±0.45)respectively,the difference was statistically significant(P<0.05,t value was 2.337).The DAS28 scores before and after treatment were positively correlated with the early enhancement rates in the fourth phase before and after treatment,and the correlation coefficients r were 0.744 and 0.806,P value was 0.01,respectively.Conclusion The shape of dynamic enhanced TIC curve and early enhancement rate of MR have high v
作者
傅丽晖
张瑾
梁良
FU Lihui;ZHANG Jin;LIANG liang(Department of Radiolohgy,Ningbo Lihuili Hosptial,Ningbo 315041,P.R.China;Department of Rheuma,Ningbo Lihuili Hosptial,Ningbo 315041,P.R.China)
出处
《医学影像学杂志》
2019年第5期828-832,共5页
Journal of Medical Imaging
关键词
类风湿性关节炎
磁共振成像
动态增强
滑膜
生物制剂
Rheumatoid arthritis
Magnetic resonance imaging
Dynamic enhancement
Synovia
Biological agents
