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全身磁共振成像可以预测青少年无形性关节炎的复发吗? 一个纵向试点研究

Deeksha Bhalla¹, Narendra Bagri², Manisha Jana¹

¹From the Departments of Radiodiagnosis.

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases

|October 2, 2023

概括

全身MRI可以预测青少年异常性关节炎 (JIA) 在缓解期的儿童的复发. 在WBMRI上检测到的鼻膜炎是未来疾病活动的最强有力的指标.

科学领域:

儿科风湿病学儿科风湿病学
诊断成像诊断成像诊断成像
医学生物标志物医学生物标志物

背景情况:

青少年异常性关节炎 (JIA) 是一种慢性自身免疫性疾病,影响儿童.
在JIA中实现临床缓解是治疗的主要目标.
预测复发对于优化长期管理和预防关节损伤至关重要.

研究的目的:

评估全身磁共振成像 (WB MRI) 在预测JIA儿科患者复发中的有效性.
确定特定的MRI发现,与儿童实现缓解的疾病复发相关.

主要方法:

一项纵向试点研究包括了符合华莱士缓解标准的患有JIA的儿童.
进行全身MRI,并开发了一种放射性评分,以评估肌炎,骨髓胀,神经炎,肠炎和侵蚀.
后勤回归和接收器运行特征 (ROC) 曲线分析被用来确定复发的预测因素.

主要成果:

在24个月的22名儿童中,5名儿童复发,最常见的是膝盖.
单变量分析确定了突炎和总WBMRI得分作为复发的显著预测指标 (OR分别为9.46和2.8).
多变量分析表明炎和MRI总分数接近统计学意义 (p=0.06),而临床/实验室变量并不显著. ROC曲线显示了良好的预测值 (0.79-0.87).

结论:

在WBMRI上可视化的鼻膜炎是JIA缓解期儿童疾病复发的最强有力的独立预测因素.
WB MRI,特别是对突炎的评估,为缓解期的JIA患者提供了宝贵的预后信息.

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