类风湿性关节炎患者腕关节的多普勒超声积分与OMERACT RAMRIS骨髓水肿和滑膜相关...

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Ultraschall Med. 2011 Jan 21. [Epub ahead of print]

Ultrasound Doppler Score Correlates with OMERACT RAMRIS Bone Marrow Oedema and Synovitis Score in the Wrist Joint of Patients with Rheumatoid Arthritis.

Boesen M, Ellegaard K, Boesen L, Cimmino MA, Jensen PS, Terslev L, Torp-Pedersen S, Danneskiold-Samsøe B, Bliddal H.

Radiology, Frederiksberg Hospital.

Abstract

PURPOSE: MRI is considered the standard of reference for advanced imaging in rheumatoid arthritis (RA). However, in daily clinical practice ultrasound (US) imaging with Doppler information is more versatile and often used for fast and dynamic assessment of joint inflammation. The aim was to compare low-field MRI scores with the US Doppler measurements in the wrist joint of patients with RA.

MATERIAL AND METHODS: Fifty consecutive patients with RA (46 women & 4 men) completed both low-field dedicated extremity MRI (E-scan®, Esaote) and a high-end US (Sequioa®, Siemens) imaging of the wrist before initiating either biological treatment (n = 26) or intraarticular injection of Depomedrole® (n = 24). Mean age was 56 years (range 21 - 83 years); mean disease duration 87.2 months (range 4 - 349 months), mean DAS 28 4,8 (range 2 - 7). MRI was scored according to the OMERACT RAMRIS recommendations and US Doppler colour-fractions were determined.

RESULTS: Using Spearman's rho, we found a relatively good to moderate correlation between the US colour-fraction and the total OMERACT bone marrow oedema and synovitis scores on MRI (r = 0.6; p < 0.001 and r = 0.4; p < 0.006 respectively). There was a trend but no significant correlation with the total OMERACT erosion score (r = 0.3; p = 0.06).

CONCLUSION: Within limits, the OMERACT RAMRIS scores of inflammation in RA patients (bone marrow oedema and synovial enhancement) are comparable to the US colour-fraction measurements using a high-end US scanner. Both imaging modalities detect inflammation although showing different aspects of the inflammatory process in the wrist joint. The higher correlation between US colour-fractions and MRI bone marrow oedema indicates a potential importance of US Doppler in monitoring inflammatory disease changes in RA.

类风湿性关节炎患者腕关节的多普勒超声积分与OMERACT RAMRIS骨髓水肿和滑膜相关

Boesen M, Ellegaard K, et al,Ultraschall Med. 2011 Jan 21. [Epub ahead of print]

目的:核磁共振成像(MRI)被认为是类风湿关节炎(RA)高级影像的参考标准。然而,在日常临床实践中多普勒超声（US）成像用途更广,经常被用于关节炎症的快速和动态评估。本研究目的是比较低场MRI评分和多普勒超声测量对RA患者腕关节的评估作用。

材料和方法:50例连续RA患者(46例女性和4例男性)在开始生物制剂治疗(n = 26)或关节内Depomedrole®注射(n = 24)前同时接受低场MRI（E-scan®，Esaote）和高端超声(Sequioa®，Siemens)腕关节成像。患者平均年龄为56岁(范围：21 – 83岁),平均病程87.2个月(范围4 - 349个月),平均DAS28 4.8(范围2 - 7)。根据OMERACT（RA临床试验结果评价） RAMRIS（RA的MRI评分）的建议对MRI进行评分并检测彩色多普勒超声。

结果:用Spearman's rho统计方法,我们发现彩色多普勒超声与MRI中的OMERACT骨髓水肿和滑膜炎有较好的相关性 (r = 0.6;p < 0.001,r = 0.4;p < 0.006)。与总OMERACT侵蚀评分有相关的趋势,但未达到统计学意义 (r = 0.3;p = 0.06)。

结论:在一定范围内,RA患者OMERACT RAMRIS的炎症评分(骨髓水肿及滑膜增强)与高端探头的彩色多普勒超声扫描是可比的。尽管显示的是腕关节炎症过程的不同方面，但两种成像技术检测都可以检测炎症。彩色多普勒超声与MRI骨髓水肿的高相关性显示多普勒超声在检测RA患者炎症性变化过程的重要潜在作用。

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