什么时候MRI在没有证据证明X射线图上有圣炎的患者中是有用的?
Yeo-Jin Lee1, Sang Hoon Lee2, Soo-Min Ahn1
1Department of Rheumatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Seoul, 05505, Republic of Korea.
Rheumatology international
|September 21, 2023
概括
磁共振成像 (MRI) 可以在没有放射性神经炎的患者中诊断轴性脊髓关节病 (AxSpA). 人类白细胞抗原 (HLA) -B27阳性和血小板数升高是推MRI的关键指标.
科学领域:
- 类风湿病学 类风湿病学
- 放射学 放射学是一门学科.
- 免疫遗传学 免疫遗传学
背景情况:
- 轴性脊柱关节炎 (AxSpA) 诊断在没有放射性神经炎的情况下可能是具有挑战性的.
- 早期诊断对于有效管理和预防疾病进展至关重要.
研究的目的:
- 为了确定磁共振成像 (MRI) 在诊断AxSpA在怀疑疾病但没有射线证据的患者的实用性.
- 确定临床和实验室预测因子,以通过MRI检测这种患者群体中的圣炎.
主要方法:
- 对105名怀疑AxSpA和正常初始X射线图的患者的回顾性审查.
- 分析临床特征,实验室标记 (包括HLA-B27,CRP,WBC,血小板计数) 和MRI发现.
- 多变量分析以确定MRI上与神经炎的显著关联.
主要成果:
- 三分之一的患者 (34/105) 在MRI上表现出神炎,尽管X射线图正常.
- MRI阳性和MRI阴性组之间的显著差异包括HLA-B27阳性 (79.4%vs. 40.0%),白血球计数,血小板计数和CRP水平.
- 多变量分析确定了HLA-B27阳性和血小板计数作为MRI上神经炎的显著预测因素.
结论:
- 在怀疑AxSpA和正常X射线图的患者中,MRI对于诊断神经炎是有价值的.
- 考虑对疑似AxSpA的患者进行MRI,这些患者HLA-B27阳性,血小板数量升高.
- 这些发现有助于优化早期检测AxSpA的诊断策略.
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