检测类风湿性关节炎患者一年内的新侵蚀--手指关节的 X 射线照相术和高分辨率计算机断层扫描。

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine Pub Date : 2025-01-01 DOI:10.1016/j.jbspin.2024.105812

Josephine Therkildsen , Rasmus Klose-Jensen , Mathias Hänel , Bente L. Langdahl , Jesper S. Thomsen , Sarah L. Manske , Kresten K. Keller , Ellen-Margrethe Hauge

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引用次数: 0

摘要

目的比较通过高分辨率外周定量计算机断层扫描（HR-pQCT）和传统放射摄影（CR）评估的两个掌指关节（MCP）一年内新侵蚀的数量。此外，以高分辨率外周定量计算机断层扫描（HR-pQCT）为参考标准，评估CR对侵蚀性进展的诊断准确性：方法：对接受HR-pQCT和CR检查的RA患者（n=310）提供了成对的图像数据集，这些患者在基线和一年随访时仅接受了包括惯用手第2和第3MCP关节在内的检查。通过 HR-pQCT 和 CR 确定侵蚀数量。侵蚀体积根据分段的 HR-pQCT 图像估算，侵蚀评分根据 CR 用 Sharp/van der Heijde 方法获得。侵蚀进展的定义是侵蚀总数的增加或研究指定的侵蚀总体积或侵蚀总分的增加：基线时，CR确定了250处糜烂，而HR-pQCT确定了1864处糜烂。一年后，CR 发现了 3 个新的糜烂，而 HR-pQCT 发现了 66 个新的糜烂。使用 HR-pQCT 的 40 例患者和使用 CR 的 3 例患者均发现了侵蚀进展。以HR-pQCT为参考，CR检测侵蚀进展的敏感性为2.5%（95% CI：0.1-13.2%），特异性为99.3%（95% CI：97.3-99.9%）：结论：HR-pQCT发现的新糜烂数量是CR的20倍以上，糜烂进展患者的数量是CR的10倍以上。HR-pQCT是监测RA一年内新发侵蚀和侵蚀进展的灵敏工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Detecting new erosions in rheumatoid arthritis over one year – Radiography and high-resolution computed tomography of finger joints

Objective

To compare the number of new erosions in two metacarpophalangeal (MCP) joints over one year assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) and conventional radiography (CR). Furthermore, to estimate the diagnostic accuracy of erosive progression by CR with HR-pQCT as the reference standard.

Methods

Paired sets of image data were available from patients with RA (n = 310), who underwent HR-pQCT and CR, including the 2nd and 3rd MCP joints only of the dominant hand at baseline and at the one-year follow-up. Erosion number was determined using HR-pQCT and CR. Erosive volume was estimated from segmented HR-pQCT images, and erosion scores were obtained by the Sharp/van der Heijde method from CR. Erosive progression was defined as an increase in total erosion number or a study-specified increase in total erosive volume or total erosion score.

Results

At baseline, 250 erosions were identified by CR compared to 1864 erosions by HR-pQCT. After one year, 3 new erosions were detected by CR compared to 66 new erosions by HR-pQCT. Erosive progression was identified in 40 patients using HR-pQCT and in 3 patients using CR. With HR-pQCT as reference, CR had a sensitivity of 2.5% (95% CI: 0.1–13.2%) and a specificity of 99.3% (95% CI: 97.3–99.9%) for detecting erosive progression.

Conclusion

HR-pQCT identified more than 20 times the number of new erosions, and more than 10 times as many patients with erosive progression than CR. HR-pQCT is a sensitive tool for monitoring new erosions and erosive progression over one year in RA.

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来源期刊

Joint Bone Spine 医学-风湿病学

CiteScore

4.50

自引率

11.90%

发文量

184

审稿时长

25 days

期刊介绍： Bimonthly e-only international journal, Joint Bone Spine publishes in English original research articles and all the latest advances that deal with disorders affecting the joints, bones, and spine and, more generally, the entire field of rheumatology. All submitted manuscripts to the journal are subjected to rigorous peer review by international experts: under no circumstances does the journal guarantee publication before the editorial board makes its final decision. (Surgical techniques and work focusing specifically on orthopedic surgery are not within the scope of the journal.)Joint Bone Spine is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.