类风湿关节炎相关肌少症的影像学研究进展

王晓波; 鄂林宁

doi:10.15953/j.ctta.2023.168

类风湿关节炎相关肌少症的影像学研究进展

王晓波^1,,
鄂林宁^2, ,

1.
山西医科大学医学影像学院, 太原030001
2.
山西白求恩医院（山西医学科学院）放射科, 太原030032

基金项目: 山西省医学重点科研项目（基于深度学习算法的间质性肺病评估模型开发（2022XM42））。

详细信息

作者简介:
王晓波: 女，山西医科大学放射影像学在读硕士研究生，主要从事身体成分影像学研究，E-mail：wangxiaobo161@163.com

通讯作者:
鄂林宁: 男，山西白求恩医院（山西医学科学院）放射科主任医师、硕士生导师，主要从事胸部疾病影像学研究，E-mail：elinning@163.com。

中图分类号: R 814；R 445
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出版历程
- 收稿日期: 2023-08-29
- 录用日期: 2023-12-12
- 网络出版日期: 2023-12-19
- 刊出日期: 2024-02-29

Imaging of Sarcopenia in Rheumatoid Arthritis: State of the Art

WANG Xiaobo^1,,
E Linning^2, ,

1.
College of Medical Imaging, Shanxi Medical University, Taiyuan 030001, China
2.
Department of Radiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, China

摘要

摘要:
类风湿关节炎（RA）早期便可并发肌少症，肌少症可增加RA患者骨质疏松、骨折等疾病的风险。RA患者处于活动期时，力量和功能的评估受限于关节活动，因此对肌肉量及肌肉质量的评估尤为重要。影像学检查技术可定量评估RA患者的肌肉量及肌肉质量，是诊断RA相关肌少症的重要手段。本文旨在对各种影像学技术在RA相关肌少症中的研究进展进行总结。
- 影像学技术 /
- 类风湿关节炎 /
- 肌少症
Abstract:
Early-stage rheumatoid arthritis (RA) often harbors a hidden threat: sarcopenia, a silent contributor to osteoporosis and fractures. Assessing muscle mass and quality, particularly during active RA periods when joint mobility hinders strength and function evaluations, becomes crucial. Imaging techniques emerge as invaluable tools in this diagnostic puzzle, offering accurate quantification of muscle status in RA patients. This article delves into advancements of various imaging modalities in unraveling RA-related sarcopenia.
- rheumatoid arthritis /
- sarcopenia /
- imaging techniques

HTML全文

表 1 RA相关肌少症的影像学评估方法

Table 1 Comparison of imaging methods for sarcopenia assessment in rheumatoid arthritis

影像学检查技术	常用检查部位或测量点	常用测量指标或参数	优点	缺点
DXA	四肢（双上肢+双下肢）	ALM、ALMI	应用广，快速、成本低、辐射剂量低、有确定的临界值	受患者体内水分变化的影响，难以对肌肉质量评估、难以准确测定躯干肌肉
CT	测定部位不统一，大腿中部层面应用广泛	肌肉量：SMA、SMI 肌肉质量：IMAT、SMD	金标准，定量测量不同层面或区域的肌肉和脂肪组织，扫描仪器较小、扫描时间较短及辐射剂量较低	临界值争议大，无法准确区分IMAT和IntraMAT，辐射量较大
MRI	测定部位不统一，大腿中部层面应用广泛	肌肉量：SMA、SMI 肌肉质量：Dixon技术为最常用的定量测定脂肪的方法、DTI及MRE可评估肌纤维结构的微观变化等	金标准，无辐射、多参数和软组织分辨率高的优势，且更好的区分IMAT和IntraMAT	其成本高、禁忌症多、扫描和后处理时间，缺乏标准化的成像方案和测定指标
US	测定部位不统一，股四头肌（尤股直肌）	肌肉量：肌肉厚度、横截面积、肌肉体积肌肉质量：肌束长度、羽状角；回声强度、肌肉弹性、肌肉收缩潜力	初筛，便携、快速、禁忌症少、无辐射	受患者检查体位、肌肉收缩状态及操作者探头位置、压力、倾斜角等影响，指标的临界点不明确
注：DXA：双能X线吸收测定法；ALM：四肢瘦体重；ALMI：四肢瘦体重指数；CT：计算机断层扫描；SMA：骨骼肌横截面积；SMI：骨骼肌指数；IMAT：肌间脂肪组织；SMD：骨骼肌密度；IntraMAT：肌内脂肪组织；MRI：磁共振成像；Dixon技术：水-脂分离技术；DTI：扩散峰度成像；MRE：磁共振弹性成像；US：超声。

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