Application of wrist MRI combined anti-cyclic citrullinated peptide antibody detection in the diagnosis of early rheumatoid arthritis / 中国医师杂志

ABSTRACT

Objective To study the clinical value of wrist magnetic resonance imaging (MRI) combined anti-cyclic citrullinated peptide antibody detection in the diagnosis of early rheumatoid arthritis (RA).Methods Forty five patients with early RA were selected as RA group,45 cases of patients without rheumatoid arthritis as non-RA group,and 43 cases of people with normal examination as control group.All subjects were given wrist MRI and anti-cyclic citrullinated peptide (CCP) antibody with the enzyme linked immunosorbent assay (ELISA).At the same time,clinical symptoms,physical signs,MRI manifestations,and laboratory indicators were collected.All results were statistically analyzed.Results Positive rate of MRI lesions and serum anti-CCP antibody in RA group were significantly higher than non-RA group and control group (P ＜0.05).The sensitivity and specificity of MRI (or anti-CCP antibody) for early RA were 88.88％ and 82.22％ (or 68.88％ and 91.11％).The sensitivity (64.44％) of MRI combined with anti-CCP antibody was decreased compared to individual; however,the specificity (100％) of MRI combined with anti-CCP antibody was increased.The correlation of MRI synovial scores and anti-CCP antibody levels was positively correlated (rs =0.612,P ＜ 0.05).MRI abnormal signs and joint disease activity score (DAS28) were positively correlated (rs =0.521,P ＜ 0.05).Anti-CCP antibody levels and DAS28 were positively correlated (rs =0.541,P ＜ 0.05).Conclusions MRI examination and combined with anti-CCP antibody detection is helpful to improve the diagnosis of early RA,and it provides a detection basis for dynamic assessment of RA condition changes.