膝关节类风湿性滑膜病变超声与MRI检查结果的比较-东南大学学报医学版

膝关节类风湿性滑膜病变超声与MRI检查结果的比较

单位：1. 江苏省中医院, 江苏南京 210029;
2. 东南大学医学院, 江苏南京 210009

分类号：R593.22

出版年·卷·期（页码）：2014·33·第六期（747-751）

摘要：

目的: 通过对类风湿关节炎(RA)膝关节滑膜病变超声与MRI表现的对比,分析高频超声诊断RA膝关节滑膜病变与MRI的相关性.方法: 对临床确诊RA的30例患者患侧膝关节和20例正常对照者双侧膝关节行超声检查,在相同切面测量滑膜厚度,并进行对比分析.对RA组患侧膝关节行MRI检查,在超声和MRI相同的切面上观察滑膜病变情况,对比分析两种影像学检查结果.结果: RA组髌骨上、内外侧髁滑膜较对照组明显增厚(P<0.001);超声和MRI均显示滑膜增厚,超声测量的滑膜厚度与MRI测值无明显差异(P>0.1);超声与MRI对滑膜增厚分级具有较好的相关性(P<0.001).结论: 超声对膝关节类风湿性滑膜病变的检查结果与MRI具有较好的相关性,在临床应用中可作为诊断RA膝关节滑膜病变的首选检查方法.

Objective: To analyze the correlation between high-frequency ultrasound and MRI,by comparing the results of ultrasound and MRI respectively in knee synovial lesions of RA. Methods: Affected knee of 30 patients with clinically diagnosed RA and bilateral knee of 20 normal controls were examined by ultrasound and MRI respectively to obtain the knee synovial thickness. The images were then compared. Results: The synovium of RA group was significantly thicker than that of the control group(P<0.001).In the RA group,ultrasound and MRI all can show the incrassate synovium and there is no significant difference in the measurement of synovial thickness between them(P>0.1).There is also higher correlation between ultrasound and MRI in the grade of synovial thickness(P<0.001). Conclusion: The inspection results of knee rheumatoid synovial lesion is more correlated to MRI than ultrasound. Ultrasound can be used as the preferred method of examination to diagnose knee synovial lesions in clinical application.

参考文献：

[1] FAUCI A S,LANGFORD C A.哈里森风湿病学[M].田新平,曾小峰,译.北京: 人民卫生出版社,2009: 74-85.
[2] ALETAHA D,NEOGI T,SILMAN A J,et al.2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism Collaborative Initiative[J].Ann Rheum Dis,2010,69(9): 1580-1588.
[3] HARTUNG W,KELLNER H,STRUNK J,et al.Development and evaluation of a novel ultrasound score for large joints in rheumatoid arthritis: one year of experience in daily clinical practice[J].Arthritis Care Res(Hoboken),2012,64(5): 675-682.
[4] COUMBARAS M,LEHIR P,SAUTET A,et al.Reactive synovitis: MRI features with arthroscopic correlation[J].Radiol,2005,86(5): 481-486.
[5] SKINNER S.MRI of the knee[J].Aust Fam Physician,2012,41(11): 867-869.
[6] BACKHAUS M,KAMRADT T,SANDROCK D,et al.Arthritis of the finger joints: a comprehensive approach comparing conventional radiography,scintigraphy,ultrasound,and contrast-enhanced magnetic resonance imaging[J].Arthritis Rheum,1999,42(6): 1232-1245.
[7] WAKEFIELD R,GOH E,CONAGHAN P,et al.Musculoskeletal ultrasonography in Europe results of a rheumatologist-based survey at a EULAR meeting[J].Rheumatology,2003,42: 1251-1253.
[8] 李文春,李振强.膝关节滑膜囊的应用解剖[J].中国临床解剖学杂志,1994,12(3): 189-191.
[9] VLAD V,BERGHEA F,LIBIANU S,et al.Ultrasound in rheumatoid arthritis: volar versus dorsal synovitis evaluation and scoring[J].BMC Musculoskelet Disord,2011,3(12): 124.
[10] WALTHER M,HARMS H,KRENN V,et al.Synovial tissue of the hip at power Doppler US: Correlation between vascularity and power Doppler US signal[J].Radiology,2002,225(1): 225-231.
[11] 邱逦,罗燕,彭玉兰.超声对于类风湿性关节炎膝关节滑膜病变的研究[J].中国医学影像技术,2005,21(11): 1372-1374.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录