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首页> 外文期刊>BMC Rheumatology >Dissociation between 2-[ 18 F]fluoro-2-deoxy-D-glucose positron emission computed tomography, ultrasound and clinical assessments in patients with non-severe rheumatoid arthritis, including remission
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Dissociation between 2-[ 18 F]fluoro-2-deoxy-D-glucose positron emission computed tomography, ultrasound and clinical assessments in patients with non-severe rheumatoid arthritis, including remission

机译：2- [18 f]氟-2-脱氧-D-葡萄糖正电子发射的解剖学，超声波和临床评估，在非严重类风湿性关节炎的患者中，包括缓解

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Inflammation of patients joints with severe disease activity of rheumatoid arthritis (RA) has already been visualized and quantified by 2-[18F]fluoro-2-deoxy-D-glucose positron emission computed tomography ([18F] FDG PET/CT), but little is known about the metabolic status and its relationship with clinical and ultrasonography (US) metrology in patients with low/moderate activity or in remission. Clinical assessments [based on 28-joint disease activity score (DAS28-CRP) and Clinical Disease Activity Index (CDAI)], [18F] FDG PET/CT, US and X-ray were performed on 63 RA patients classified into remission or low/moderate or severe disease activity groups. PET/CT was visually and then semi-quantitatively analysed by determining the standardized uptake value (SUV) of positive joints. Of the 1764 joints, 21.1% were tender only, 13.7% swollen only, 27.6% tender or swollen, 7.3% tender and swollen, 20.5% PET/CT-positive and 8.6% US-positive. PET and US measurements were correlated, albeit with poor concordance. The positive predictive value of PET/CT for clinical evaluation (tender and/or swollen) was low, whereas its negative predictive value was high. Highly significant differences were found with the number of PET/CT-positive joints and with cumulative SUV between “severe” and “non-severe” patients (including those in remission and those with low/moderate activity) and not between those classified as “remission” and “non-remission” or “remission” and “low/moderate activity”. Moreover, the correlation between PET/CT measurements and clinical activity was positive only in the CDAI severe disease group. In patients in remission or with low/moderate activity, only 20–30% of joints were PET/CT-negative. In remission, PET/CT and US were positive in different joints, and PET/CT-positive but US-negative joints mainly exhibited RA (38.1%) or normal (49.2%) and not osteoarthritic (12.7%) X-ray patterns. [18F] FDG PET/CT was effective at distinguishing patients with severely active disease from other patients. In non-severe RA patients, including those in remission, PET/CT results are discordant from US and clinical observations. A longitudinal analysis is needed to explore the clinical relevance of such infra-clinical disease.
机译：通过2-[18F]氟-2-脱氧-D-葡萄糖正电子扫描（[18F] FDG PET / CT），已经可视化和量化了类风湿性关节炎（RA）严重疾病活性的患者患者关节的炎症已经进行了可视化和量化，但是关于代谢状况的知名，与低/中等活动或缓解患者的临床和超声检查（美国）计量的关系。临床评估[基于28-关节疾病活动评分（DAS28-CRP）和临床疾病活动指数（CDAI）]，[18F] FDG PET / CT，US和X射线在分为缓解或低的63名患者上进行/中度或严重的疾病活动组。通过测定正关节的标准化摄取值（SUV），目视直观地分析PET / CT，然后进行半定量分析。在1764年的关节中，21.1％仅嫩，仅13.7％肿胀，27.6％的嫩或肿胀，7.3％的柔软且肿胀，20.5％PET / CT阳性和8.6％美国阳性。宠物和美国测量有关，虽然有良好的一致性。 PET / CT用于临床评价（柔软和/或肿胀）的阳性预测值低，而其负面预测值很高。发现具有宠物/ CT阳性关节的数量和“严重”和“非严重”患者之间的累积患者（包括缓解剂和低/中等活动）之间的累积差异，而不是归类为“缓解“和”不缓解“或”缓解“和”低/中度活动“。此外，PET / CT测量与临床活性之间的相关性仅在CDAI严重疾病组中阳性。在缓解或低/中等活性的患者中，只有20-30％的关节是PET / CT阴性。在缓解中，PET / CT和美国在不同关节中是阳性的，PET / CT阳性但美国阴性关节主要表现出RA（38.1％）或正常（49.2％），而不是骨关节炎（12.7％）X射线图案。 [18F] FDG PET / CT在与其他患者的患者中区分患者的患者有效。在非严重的RA患者中，包括缓解剂的患者，宠物/ CT结果来自美国和临床观察。需要纵向分析来探讨此类临床疾病的临床相关性。

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