Changes of DCE-MRI Parameters in RA Patients Before and After Drug Treatment and Its Effect on Bone Erosion

doi:10.7517/issn.1674-0475.221034

Abstract

Abstract: This paper investigated the changes in quantitative parameters of dynamic enhanced magnetic resonance imaging (DCE-MRI) before and after drug treatment for rheumatoid arthritis (RA) and the effects on bone erosion. 112 patients with RA were selected, and quantitative parameters[maximum enhancement (Emax), maximum relative enhancement (REmax), relative enhancement (RE), and slope of maximum enhancement (Slopemax)] were measured by DCE-MRI before and after drug treatment to compare quantitative DCE-MRI parameters and bone erosion scores before and after treatment in patients with and without response. The results showed that Emax, REmax, RE, and Slopemax in non-responders were higher than in responders before and after treatment, and the change values of Emax, REmax, RE, and Slopemax before and after treatment were lower than those of responders (P<0.05). The change values of Emax, REmax, RE, and Slopemax before and after treatment were positively correlated with drug treatment in RA patients(P<0.05). The area under the curve (AUC) of the combination of Emax, REmax, RE, and Slopemax before treatment to predict RA drug treatment responsiveness as non-response was 0.901 (95% CI:0.830-0.949). The bone erosion scores before and after treatment in non-responders were higher than in responders, and the change in bone erosion scores before and after treatment was lower than in responders (P<0.05). The values of Emax, REmax, RE, and Slopemax before and after treatment were positively correlated with the change in bone erosion score in RA patients (P<0.05). It can be seen that the quantitative parameters Emax, REmax, RE, and Slopemax of DCE-MRI before treatment can predict the responsiveness to RA drug treatment, and the change values of each parameter are closely related to the change of bone erosion.

Key words: rheumatoid arthritis, dynamic enhanced magnetic resonance imaging, efficacy, bone erosion

ZHENG Yi, JIANG Yingchun, YANG Hao, DONG Zhanjun, CHEN Yan, LI Siqiang. Changes of DCE-MRI Parameters in RA Patients Before and After Drug Treatment and Its Effect on Bone Erosion[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2023, 41(1): 136-141.

References

[1] 中国医师协会风湿免疫科医师分会自身抗体检测专业委员会,国家风湿病数据中心,国家皮肤与免疫疾病临床医学研究中心. 类风湿关节炎相关自身抗体检测的临床应用专家共识[J]. 中华内科杂志,2021,60(6):516-521.
[2] Sparks J A. Rheumatoid arthritis[J]. Annals of Internal Medicine,2019,170(1):ITC1-ITC16.
[3] 田新平, 李梦涛, 曾小峰. 我国类风湿关节炎诊治现状与挑战:来自中国类风湿关节炎2019年年度报告[J]. 中华内科杂志, 2021, 60(7):593-598.
[4] 黄杰, 丁建平, 王绍武, 等. DCE-MRI对类风湿性关节炎活动性定量研究的价值[J]. 临床放射学杂志, 2020, 39(9):1843-1847.
[5] Chen D G, He S Q. Changes of DCE-MRI parameters in patients with rheumatoid arthritis before and after therapy and their value for the efficacy evaluation of patients[J]. Evidence-Based Complementary and Alternative Medicine, 2021, 2021(1):6848359.
[6] 中华医学会风湿病学分会. 2018中国类风湿关节炎诊疗指南[J]. 中华内科杂志, 2018, 57(4):242-251.
[7] Vergneault H, Vandebeuque E, Codullo V, et al. Disease activity score in 28 joints using GGT permits a dual evaluation of joint activity and cardiovascular risk[J]. The Journal of Rheumatology, 2020, 47(12):1738-1745.
[8] 高鹏, 李静, 刘宇宏, 等. 类风湿关节炎患者骨髓水肿和骨侵蚀的MRI联合CT诊断情况及预后相关性[J]. 中国CT和MRI杂志, 2019, 17(11):139-142.
[9] Sundin U, Østergaard M, Glinatsi D, et al. Validity and responsiveness of combined inflammation and combined joint damage scores based on the OMERACT rheumatoid arthritis MRI scoring system (RAMRIS)[J]. The Journal of Rheumatology, 2019, 46(9):1222-1227.
[10] 王喆, 黄国强, 赵小莹, 等. 膝关节腔内注射甲氨蝶呤和益赛普对老年类风湿关节炎的疗效影响[J]. 贵州医药, 2022, 46(4):539-541.
[11] 许俊, 付晓雅, 杨玲, 等. 28关节多普勒超声评分对类风湿关节炎的影响[J]. 中国医药导报, 2019, 16(13):83-87.
[12] Takanashi S, Kaneko Y, Takeuchi T. CDAI and DAS28 in the management of rheumatoid arthritis in clinical prac-tice[J]. Annals of the Rheumatic Diseases, 2020, 79(5):671-674.
[13] Cimmino M A, Parodi M, Barbieri F, et al. Dynamic contrast-enhanced MRI confirms rapid and sustained improvement of rheumatoid arthritis induced by tocilizumab treatment:An Italian multicentre study[J]. Biologics:Targets and Therapy, 2020, 14(1):13-21.
[14] 郑婧, 任水明, 张凤翔, 等. DCE-MRI检查五项参数与类风湿关节炎疾病活动度关系及临床价值[J]. 影像科学与光化学, 2021, 39(5):721-726.
[15] Axelsen M B, Boesen M, Bliddal H, et al. Responsiveness of different dynamic contrast-enhanced magnetic resonance imaging approaches:A post-hoc analysis of a randomized controlled trial of certolizumab pegol in rheumatoid arthritis[J]. Scandinavian Journal of Rheumatology, 2020, 49(2):105-111.
[16] 刘元君. 动态增强MRI和肌骨超声对类风湿关节炎活动性的诊断价值比较[J]. 中国CT和MRI杂志, 2021, 19(5):173-176.
[17] Li N, Jiang L, Cai Y H, et al. The correlation between interleukin-34 and bone erosion under ultrasound in rheumatoid arthritis[J]. Modern Rheumatology, 2020, 30(2):269-275.
[18] 曹国平, 罗松, 邓小毅, 等. 痛风性膝关节炎MRI骨侵蚀、骨髓水肿、滑膜炎与痛风石的相关性研究[J]. 医学影像学杂志, 2020, 30(3):456-459.