[1]忻岳军,郑劼.类风湿关节炎MRI评分系统评价类风湿关节炎疾病活动度的应用价值[J].中医正骨,2022,34(01):47-49.
　XIN Yuejun,ZHENG Jie.Application value of rheumatoid arthritis MRI scoring system in assessment of disease activity in patients with rheumatoid arthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(01):47-49.
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类风湿关节炎MRI评分系统评价类风湿关节炎疾病活动度的应用价值()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期数:
2022年01期
页码:
47-49
栏目:
临床研究
出版日期:
2022-01-20

文章信息/Info

Title:
Application value of rheumatoid arthritis MRI scoring system in assessment of disease activity in patients with rheumatoid arthritis
作者:
忻岳军1; 郑劼2
(1.宁波市第六医院,浙江 宁波 315040; 2.浙江省人民医院,浙江 杭州 310014)
Author(s):
XIN Yuejun1; ZHENG Jie2
1.Ningbo No.6 Hospital,Ningbo 315040,Zhejiang,China;2.Zhejiang Provincial People’s Hospital,Hangzhou 310014,Zhejiang,China
关键词:
关节炎; 类风湿;  腕关节;  磁共振成像;  疾病活动度
Keywords:
arthritis; rheumatoid;  wrist joint;  magnetic resonance imaging;  disease activity
摘要:
目的:探讨类风湿关节炎MRI评分系统(rheumatoid arthritis MRI scoring system,RAMRIS)评价类风湿关节炎(rheumatoid arthritis,RA)疾病活动度的应用价值。方法:纳入98例RA患者,从病历系统中提取基于28个关节计数和C反应蛋白血清含量的疾病活动度评分(disease activity score 28-C reactive protein,DAS28-CRP)及患者腕关节MRI检查结果。由2名影像专业副主任医师共同查阅患者腕关节MRI检查结果,采用RAMRIS评价患者腕部滑膜炎、骨髓水肿及骨侵蚀情况,记录滑膜炎评分、骨侵蚀评分、骨髓水肿评分及RAMRIS总分。分析2名医师对RA患者腕关节评价结果的一致性及各评分与DAS28-CRP的相关性,采用受试者操作特征曲线评价RAMRIS评价RA疾病活动度的应用价值。结果:2名医师对RA患者腕关节的MRI评价结果(滑膜炎评分、骨髓水肿评分、骨侵蚀评分、RAMRIS总分)的一致性较好(Kappa=0.788,P=0.000; Kappa=0.852,P=0.013; Kappa=0.787,P=0.000; Kappa=0.627,P=0.001)。Pearson相关性分析结果显示滑膜炎评分、骨髓水肿评分、骨侵蚀评分、RAMRIS总分均与DAS28-CRP呈正相关(r=0.471,P=0.024; r=0.321,P=0.041; r=0.433,P=0.000; r=0.545,P=0.038)。以DAS28-CRP为RA疾病活动度的评价标准,滑膜炎评分、骨髓水肿评分、骨侵蚀评分和RAMRIS总分评价RA疾病活动度的受试者操作特征曲线下面积分别为0.786(P=0.000)、0.803(P=0.000)、0.788(P=0.000)、0.812(P=0.000)。结论:RAMRIS评价RA疾病活动度具有较高的应用价值。
Abstract:
Objective:To explore the application value of rheumatoid arthritis magnetic resonance imaging(MRI)scoring system(RAMRIS)in assessment of disease activity in patients with rheumatoid arthritis(RA).Methods:Ninety-eight RA patients were enrolled in the study.The disease activity scores based on 28 joints and C-reactive protein(DAS28-CRP)and the wrist MRI examination outcomes were extracted from the Electronic Medical Record System(EMRS).The MRI outcomes were jointly reviewed by 2 associate chief physicians in medical imaging specialty.The wrist synovitis,bone marrow edema(BME)and bone erosion were assessed by using RAMRIS,and their scores as well as the total RAMRIS score were recorded.The consistency of wrist MRI assessment results between the 2 physicians and the correlation between the scores and DAS28-CRP were analyzed.The applied value of RAMRIS in assessing the disease activity of RA were evaluated by using receiver operating characteristic(ROC)curve.Results:The good consistency in wrist MRI assessment results(synovitis score,BME score,bone erosion score and total RAMRIS score)were found between the 2 physicians(Kappa=0.788,P=0.000; Kappa=0.852,P=0.013; Kappa=0.787,P=0.000; Kappa=0.627,P=0.001).The results of Pearson correlation analysis showed that the scores of synovitis,BME and bone erosion as well as total RAMRIS score were positively correlated with DAS28-CRP(r=0.471,P=0.024; r=0.321,P=0.041; r=0.433,P=0.000; r=0.545,P=0.038).With DAS28-CRP as the evaluation standard,the areas under the ROC curves established based on the scores of synovitis,BME and bone erosion as well as total RAMRIS score for assessing RA disease activity were 0.786(P=0.000),0.803(P=0.000),0.788(P=0.000)and 0.812(P=0.000)respectively.Conclusion:RAMRIS has a high application value in assessment of disease activity in patients with RA.

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更新日期/Last Update: 1900-01-01