USE OF MAGNETIC-RESONANCE-IMAGING AND POSITRON EMISSION TOMOGRAPHY IN THE ASSESSMENT OF SYNOVIAL VOLUME AND GLUCOSE-METABOLISM IN PATIENTS WITH RHEUMATOID-ARTHRITIS

被引：110

作者：

POLISSON, RP ^{[1
]}

SCHOENBERG, OI ^{[1
]}

FISCHMAN, A ^{[1
]}

RUBIN, R ^{[1
]}

SIMON, LS ^{[1
]}

ROSENTHAL, D ^{[1
]}

PALMER, WE ^{[1
]}

机构：

[1] HARVARD UNIV,NEW ENGLAND DEACONESS HOSP,SCH MED,BOSTON,MA

来源：

ARTHRITIS AND RHEUMATISM | 1995年 / 38卷 / 06期

关键词：

D O I：

10.1002/art.1780380616

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective. To measure the anatomic and physiologic changes in the synovium of patients with active rheumatoid arthritis (RA) before and after the initiation of treatment with low-dose systemic glucocorticoids and methotrexate (MTX), Methods, Two patients with RA with active synovitis-involving the carpus we're evaluated by imaging parameters at baseline and again after 14 weeks (of treatment with low-dose prednisone and MTX), Standard clinical parameters, laboratory measurements, and contrast-enhanced magnetic resonance imaging (MRI) (synovial volume estimate) and positron emission tomography (PET) with F-18-fluoro-2-deoxyglucose (18-FDG) (synovial metabolism estimate) were performed, Results, Compared with baseline, standard clinical parameters (i,e,, joint count, joint index, morning stiffness, global assessments of arthritis activity, and erythrocyte sedimentation rate) improved dramatically in both patients after treatment with low-dose prednisone and MTX, In concert with this trend, the synovial volume of the affected wrist was reduced by 60%, and 76% and the metabolism of 18-FDG was reduced by 66% and 69% in the 2 patients, Conclusion, These preliminary observations indicate that a volumetric estimate of inflamed synovium (using contrast-enhanced MRI) and quantification of synovial deoxyglucose metabolism (using PET) are technically feasible and, in the 2 reported casts, correlate well with standard outcome measures; These imaging modalities may provide new objective parameters to determine RA disease activity and effectiveness of antirheumatic medications; however, the potential clinical utility of these measures remains to be defined.

引用

页码：819 / 825

页数：7

共 12 条

[1]

Eberl DR, Fasching V, Rahlfs V, Schleyer I, Wolf R, Repeatability and objectivity of various measurements in rheumatoid arthritis: a comparative study, Arthritis Rheum, 19, pp. 1278-1286, (1976)

[2]

Felson DT, Anderson JJ, Boers M, Bombardier C, Chernoff M, Fried B, Furst D, Goldsmith C, Kieszak S, Lightfoot R, Paulus H, Tugwell P, Weinblatt M, Widmark R, Williams HJ, Wolfe F, The American College of Rheumatology preliminary core set of disease activity measures for rheumatoid arthritis clinical trials, Arthritis Rheum, 36, pp. 729-740, (1993)

[3]

Gilkeson G, Polisson R, Sinclair H, Vogler J, Rice J, Caldwell D, Spritzer C, Martinez S, Early detection of carpal erosions in patients with rheumatoid arthritis: a pilot study of magnetic resonance imaging, J Rheumatol, 15, pp. 1361-1366, (1988)

[4]

Kursunoglu-Brahme S, Riccio T, Wetaman M, Resnick D, Zvaifler N, Sanders ME, Fix C, Rheumatoid knee: role of gadopentetate‐enhanced MR‐imaging, Radiology, 176, pp. 831-835, (1990)

[5]

Yanagawa A, Takano K, Nishioka K, Shimada J, Mizushima Y, Ashioa H, Clinical staging and gadolinium‐DTPA enhanced images of the wrist in rheumatoid arthritis, J Rheumatol, 20, pp. 781-784, (1993)

[6]

Hawkins RA, Hoh C, Glaspy J, Choi Y, Dahlbom M, Rege S, Messa C, Nietszche E, Hoffman E, Seeger L, Maddahi J, Phelps ME, The role of positron emission tomography in oncology and other whole‐body applications, Semin Nuclear Med, 22, pp. 268-284, (1992)

[7]

Hoffman JM, Hanson MW, Coleman RE, Clinical positron emission tomography imaging, Radiol Clin North Am, 31, pp. 935-959, (1993)

[8]

Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS, Medsger TA, Mitchell DM, Neustadt DH, Pinals RS, Schaller JG, Sharp JT, Wilder RL, Hunder GG, The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis, Arthritis Rheum, 31, pp. 315-324, (1988)

[9]

Disler DG, Marr DS, Rosenthal DI, Three‐dimensional reconstruction accuracy of volume measurements of phantoms with clinical trial, Invest Radiol, 29, pp. 739-745, (1994)

[10]

Zasadny KR, Wohl RL, Standardized uptake values of normal tissues at PET with 2‐[Fluorine‐18]‐fluoro‐2‐deoxy‐D‐glucose: variations with body weight and method for correction, Radiology, 189, pp. 847-850, (1993)

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