目的探讨影像学诊断方法在类 风湿性关节炎(RA)患者临床早期诊断、治 疗及预后评估中的应用。方法 回顾性分 析患者的临床资料，将其按照病程的不同 分为两组且均符合RA分类标准，且均已完 成RA相关的自身抗体检查，完成了MRI、 CT等影像学检查，对MRI的图像按照类风 湿核磁共振成像评分系统(RAMRIS)进行 评分，对骨代谢的增加区进行感兴趣区 (ROI)分析并计算其摄取率。结果 治疗12 个月后，ERA组的缓解数为44例，缓解率 达80.0%；RA组的缓解数为37例，缓解率 达56.9%。两组患者中274块骨中检出了骨 髓水肿(BME)，217块骨中检出了侵蚀。单 侧MRI与双侧MRI的评分线性关系较好。本 次研究中14例患者的自身抗体均表现为阴 性；11例患者的IgM-RF呈阳性，其余抗体 呈阴性；3例患者的抗MCV抗体呈阳性， 其余抗体呈阴性；2例患者的抗CCP呈阳 性；而其余抗体的阳性率均低于这三种抗 体。RA组的抗体检出率普遍高于ERA组。 所有关节的 CT标记物的平均摄取率是 (1.27±0.24)。结论 MRI、自身抗体的滴 度和CT的摄取率对于评价疾病的进展具有 较大的临床意义。对RA的达标治疗时，可 综合临床检查、实验室指标及影像学资料 分析等方法。

Objective To explore the clinical applications values of imaging in diagnosis and treatment and post-clinical remission assessments of RA via imaging methods of MRI and CT. Methods 120 patients were divided into two groups. Autoantibodies examination was tested and disease activity was assessed. Imagines such as MRI and CT were performed and MRI images were scored by the RAMRIS system. Bone metabolism increased was analyzed by calculation of uptake ratio of the regional area of interest (ROI). Results The RAMRIS score system and correlation with clinical disease activity and autoantibodies. 40 cases of patients tested bilateral hand MRI examination. The remaining 80 patients' unilateral hand was tested. Synovitis, edema, erosion score had variance among MCV titer groups. Synovitis and erosion had significant differences among CCP groups. MRI examination revealed synovitis and BME. Tc-99m-MDP (1.59±0.26) uptake increased in 82 joints, and uptake ratio was higher than normal ones (1.15±0.09). Conclusions MRI, autoantibody titer and CT uptake ratio were meaningful to evaluate the disease progression. An integrated assessment such as clinical examination, laboratory indicators and the imaging methods could be more helpful to the treatment and slow disease progression.