腕关节早期类风湿性关节炎的MRI诊断价值  

Value of MRI in early diagnosis of wrists with rheumatoid arthritis

作　　者：沈新平[1] 庄俊汉[2] 张丽君[2] 梁立华[1] 赵清洲[1] 黄光辉[1] 吕建勋[1] 

机构地区：[1]广东医学院附属深圳市福田人民医院放射科,广东深圳518033 [2]广东医学院附属深圳市福田人民医院风湿病研究所,广东深圳518033

出　　处：《中国医学工程》2005年第1期4-6,共3页China Medical Engineering

基　　金：2004年度深圳市科技局立项;课题编号为200405200

摘　　要：目的探讨MRI对腕关节早期类风湿关节炎的诊断价值。方法搜集早期RA患者22例,女19例,男3例。临床诊断符合1987年美国风湿病协会(ARA)诊断标准。全部病例均行双腕关节X线平片及MRI检查。MRI均采用SET1WI,TSET2WI加压脂序列及增强后行Flash2dT1WI加压脂序列扫描,成像平面为横断及冠状面。结果22例患者,MRI下均见滑膜增厚及血管翳形成,其血管翳均见明显增强。22例均见骨质侵蚀、骨髓水肿及关节腔积液征像,其中15例见肌腱炎,而X线平片仅发现4例轻度骨质疏松,余18例均为阴性。结论MRI能显示类风湿关节炎的病理改变。对于临床怀疑早期类风湿关节炎,且X线平片又不能明确诊断者,建议行双腕MR检查,这有助于早期诊断。Objective To investigate the value of MRI in the early diagnos is of the wrists with rheumatoid arthritis(RA). Methods Twenty-two patients, 19 women and 3 men, were recruited. RA was diagnosed in all patients by the Ame rican Rheumatism Association(ARA) revised criteria. All patients underwent radio graphy and MR examination on both wrists. SE T1WI, TSE T2W1 and fat suppression, Flash 2 d T1WI and fat suppression in venous contrast material were performed i n the coronal and transversal planes. Results All of patients presented to s ynovial hyperplasia and pannus formation on MRI of wrists. All patients had enh anced signal intensity for pannus, which had bone erosions, bone marrow edema an d joint effusion, 15 patients had myotenositis, and of 22 patients, 4 cases with mild osteoporosis were revealed on radiographs. Conclusion MRI can find the appearances of wrists with RA. For those whose clinical show suspected RA, and radiographs couldn′t identify, MRI examination should be advised for the early diagnosis.

关 键 词：早期 腕关节 MRI诊断 X线平片 类风湿关节炎 类风湿性关节炎 患者 搜集 加压 协会 

分 类 号：R593.22[医药卫生—内科学] R681[医药卫生—临床医学]