| 任丽香.RA手腕部MRI体积定量分析的有效性评价[J].中国医学影像技术,2020,36(1): |
| RA手腕部MRI体积定量分析的有效性评价 |
| Effectiveness evaluation of MRI volume quantitative analysis of wrist in rheumatoid arthritis |
| 投稿时间：2019-06-19 修订日期：2020-01-07 |
| DOI： |
| 中文关键词: 磁共振成像 定量分析 类风湿关节炎 |
| 英文关键词:Magnetic resonance imaging Quantitative analysis Rheumatoid arthritis |
| 基金项目:类风湿关节炎MRI滑膜定性定量分析研究 |
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| 中文摘要: |
| 目的 建立体积定量分析模型，探讨手、腕部MRI定量分析在类风湿关节炎(Rheumatoid Arthritis, RA）疗效评价中的应用价值。方法 进行定量分析模型预实验及临床前瞻性研究，收集活动期30例并经规律治疗1年的RA患者，应用自主研发软件（昆明理工大学自主研发MRI体积定量分析软件）测量治疗前后同一手腕关节滑膜炎、骨髓水肿体积，并获取入组患者MRI检查同期的红细胞沉降率（Erythrocyte sedimentation rate ESR）、C反应蛋白（C-reactive protein CRP）,计算28 关节疾病活动度（DAS28）。分析治疗前后滑膜炎、骨髓水肿、CRP、ESR、DAS28的变化，并将滑膜炎、骨髓水肿变化量分别与CRP、ESR、DAS28变化量进行相关性分析。结果 体积定量分析模型预实验结果满意，测量精准。与治疗前相比，治疗后患者滑膜炎体积、骨髓水肿范围、CRP、ESR、DAS28均显著降低，差异均有统计学意义(P<0.05)。滑膜炎与骨髓水肿变化量呈强相关（r=0.61，P＜0.00）。滑膜炎、骨髓水肿变化量与ESR、CRP变化量均无明显相关性（r值为0.02-0.32，P均>0.05），滑膜炎、骨髓水肿变化量均与DAS28变化量呈中等相关（r=0.50、0.56，P=0.01、0.00）。 结论 MRI定量分析可作为一种准确客观的量化指标，应用于RA病情监测和疗效评价。 |
| 英文摘要: |
| Abstract: Objective To establish a quantitative analysis model, and to explore the application value of MRI quantitative analysis in the evaluation of curative effect of Rheumatoid arthritis (RA) of the wrist. Methods The pre-experimental and prospective study of the quantitative analysis model was carried out, and 30 patients with RA after regular treatment for 1 year were enrolled. The same wrist joint of each patient was scanned before and after treatment, and the volume of synovitis and bone marrow edema before and after treatment were measured by using the self-developed software (the self-developed quantitative analysis software was invented by Kunming University of Technology). The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and DAS28 score were also obtained. Finally,?the disease activity score of 28 joints was calculated. Changes of synovitis, bone marrow edema, CRP, ESR and DAS28 before and after treatment were analyzed, and the changes of synovitis and bone marrow edema were correlated with changes of CRP, ESR and DAS28.Results The pre-experimental results of volume quantitative analysis model are satisfactory and the measurement is accurate. Compared with before and after treatment, the volume of synovitis, the range of bone marrow edema, CRP, ESR and DAS28 of the patients were significantly reduced after treatment, with statistically significant differences (P<0.05). Synovitis was strongly correlated with changes in bone marrow edema (r=0.61, P< 0.00).Changes in synovitis and bone marrow edema were not significantly correlated with changes in ESR and CRP (r=0.02-0.32,P>0.05), while changes in synovitis and bone marrow edema were moderately correlated with changes in DAS28 r=0.50, 0.56, P=0.01, 0.00). Conclusion MRI quantitative analysis can be used as an accurate and objective quantitative index for monitoring and evaluating the curative effect of RA. |
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