BACKGROUND To evaluate the value of 3 Tesla (T) magnetic resonance imaging (MRI) changes of flexor tendon pulleys for the differentiation of psoriatic (PsA) and rheumatoid arthritis (RA), using a novel 16-channel high-resolution hand coil. METHODS Seventeen patients with active PsA, 20 patients with active RA, and 16 healthy controls (HC) underwent high-resolution 3 T MRI using the dedicated 16-channel hand coil. Images were analyzed by three independent readers for the degree of inflammatory changes, thickness of flexor tendon pulleys, and comparison to the outcome measures for RA clinical trials (OMERACT) PsA MRI score (PsAMRIS) and to its sub-scores. For correlation analyses, Spearman rho correlation was calculated. RESULTS Flexor tendon pulleys were thicker in PsA than in RA patients (mean difference 0.16 mm, p < 0.001) and HC (mean difference 0.2 mm, p < 0.001) and showed a higher degree of associated inflammatory changes (mean difference from RA 4.7, p = 0.048; mean difference from HC 14.65, p < 0.001). Additionally, there was a strong correlation of accessory pulley inflammation and PsAMRIS and its acute-inflammatory sub-scores, flexor tenosynovitis, synovitis, and periarticular inflammation (for the second digit synovitis ρ = 0.72, flexor tenosynovitis ρ = 0.7, overall PsAMRIS ρ = 0.72, p < 0.01). Similar robust correlations were evident in digits 3-5. Weaker correlations were evident in RA (synovitis ρ = 0.49, flexor tenosynovitis ρ = 0.49, periarticular inflammation ρ = 0.4). CONCLUSION The assessment of MRI changes of flexor tendon pulleys is potentially beneficial for disease detection in PsA, as well as for its distinction from RA and HC. TRIAL REGISTRATION 2014123117, December 2014.

中文翻译：

---

使用16通道手动线圈的屈肌腱滑轮的高分辨率MRI：银屑病和类风湿关节炎的疾病检测和鉴别。

背景技术为了评估3特斯拉（T）磁共振成像（MRI）改变的屈肌腱滑轮对牛皮癣（PsA）和类风湿性关节炎（RA）的鉴别作用，需要使用一种新颖的16通道高分辨率手动线圈。方法17例活动性PsA患者，20例活动性RA患者和16名健康对照（HC）使用专用的16通道手动线圈进行了高分辨率3 T MRI。由三个独立的阅读器分析图像的炎症变化程度，屈肌腱滑轮厚度以及与RA临床试验的结果指标（OMERACT）PsA MRI评分（PsAMRIS）及其子评分进行比较。为了进行相关性分析，计算了Spearman rho相关性。结果PsA的屈肌腱滑轮比RA患者厚（平均差0.16 mm，p <0。001）和HC（平均差异0.2 mm，p <0.001），并显示较高程度的相关炎症变化（与RA 4.7的平均差异，p = 0.048;与HC 14.65的平均差异，p <0.001）。此外，副滑轮炎症与PsAMRIS及其急性炎症亚评分，屈肌腱鞘炎，滑膜炎和关节周围炎之间存在很强的相关性（第二位滑膜炎ρ= 0.72，屈肌腱鞘炎ρ= 0.7，总PsAMRISρ= 0.72，p <0.01）。在数字3-5中也显示出类似的稳健相关性。RA中有较弱的相关性（滑膜炎ρ= 0.49，屈肌腱鞘炎ρ= 0.49，关节周围炎ρ= 0.4）。结论评估屈肌腱滑轮的MRI变化可能对PsA中的疾病检测以及与RA和HC的区分具有潜在的益处。