류마티스 관절염의 질병 활성도 결정에 있어서 손목 자가공명영상의 유용성

Abstract

Objective: To investigate whether the findings of wrist magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA) is representative of their disease activity. Methods: MRI and plain radiographs were performed on the wrists of 15 patients with RA. Four MRI techniques were used; T1 weighted spin echo image (T2WI), chemical fat suppression T2 weighted image (FS-T2WI) and Gadolinium-DTPA contrast enhanced T1 weighted image (CE-T1WI). Erosion scores used as radiologic index were calculated from total counts of bone erosion in all coronal planes of wrist MRI and plain radiographs. This erosion score was compared with the clinical indices (Ritchie index, grip strength, visual analogue pain scale) and laboratory indices (ESR, CRP, hemoglobin, immunoglobulins). Results: MRI erosion score of the wrist in patients with RA significantly correlated with ESR and serum IgG level, but did not correlate with global clinical indices such as grip strength and Ritchie index. MRI was especially useful in early detection of erosive bone change. Special MR images such as fat suppres-sion and Gd-DTPA enhanced images were superior to plain radiographs and conventional MR images in detecting the erosive lesion of carpal bones. Conclusions: Wrist MRI is useful in early detection of erosive bone change and may be an important tool for the measurement of disease activity in RA. We prospect that it could be used to assess the progression of the disease and the response of drug therapy.