腕关节MRI对关节炎诊断的临床价值  

Clinical value of MRI on wrists with arthritis

作　　者：马强[1] 王峻[2] 马大庆[1] 贺文[1] 勒二虎[1] 马新发[1] 左兆勇 

机构地区：[1]首都医科大学附属北京友谊医院放射科,北京100050 [2]山西医科大学附属第二医院放射科 [3]内蒙古呼伦贝尔市海拉尔农垦总医院放射科

出　　处：《中华放射学杂志》2006年第1期92-96,共5页Chinese Journal of Radiology

摘　　要：目的研究各种关节炎腕关节MRI表现,及其对关节炎的鉴别诊断的价值。方法搜集在风湿科曾有腕关节疼痛病史的门诊及住院患者151例,男45例,女106例。进行临床及双腕关节MR检查。151例中临床诊断类风湿性关节炎80例、未分化脊柱关节病29例、血清阴性脊柱关节病20例、其他结缔组织关节病22例。结果80例类风湿性关节炎均可见双侧血管翳表现,29例未分化脊柱关节病中3例可见双侧血管翳表现,24例可见单侧血管翳表现,20例血清阴性脊柱关节病中4例可见双侧血管翳表现,15例可见单侧血管翳表现;22例其它结缔组织关节病中21例可见单侧血管翳表现。MRI显示各种关节炎组单侧血管翳差异无统计学意义(χ2=6.157,P>0.05)。各种关节炎组在双侧关节血管翳方面的差异有统计学意义(χ2=126.882,P<0.001)。类风湿性关节炎与未分化脊柱关节病(χ2=94.192,P<0.001)、类风湿性关节炎与血清阴性脊柱关节病(χ2=70.354,P<0.001)、类风湿性关节炎与其他结缔组织关节病(χ2=96.174,P<0.001)差异均有统计学意义。结论MRI在各种关节炎的鉴别诊断中具有重要价值。Objective To study the appearances of various kinds of arthritis on MRI, and to assess and evaluate the role of MRI on diagnosing various kinds of arthritis. Methods One hundred and fifty-one patients with medical history of wrist pain entered the study. T1-weighted spin echo, STIR （short time inversion recovery） of both wrists, gadolinium contrast material-enhanced sequences of dominant wrists were examined in the coronal planes. MR1, plain wrist radiographs, clinical data including swollen joint and patient global assessment （AIMS）, and laboratory examinations including ESR, RF, APF, and AKA were obtained at the same time. Functional disability was assessed using the Health Assessment Questionnaire Disability Score （HAQ）. According to 1987 American Rheumatism Association（ARA） revised criteria, in 151 patients, 80 patients were diagnosed as rheumatoid arthritis, 29 patients as undifferentiated spandyloarthropathy, 20 patients as seronegative spondyloarthropathy, and 22 as other kinds of connective tissue diseases. Results All 80 patients diagnosed with rheumatoid arthritis had bilateral pannus. Among 29 patients diagnosed with undifferentiated spondyloanthropathy, 3 cases had bilateral pannus, 24 had lateral pannus. Among 20 patients diagnosed with seronegative spondyloanthropathy, 4 cases had bilateral pannus, 15 had lateral pannus. Among 22 patients diagnosed with other kinds of connective tissue disease, 21 had lateral pannus. Bilateral pannus on bilateral wrists occured in 87 patients. There were not significant difference in the unilateral pannus among patients with various arthritis（ X^2 = 6. 157;P 〉 0. 05 ）. But there were significant difference in the bilateral pannus among patients with various arthritis（ X^2 = 126. 882, P 〈 0. 001）. There were significant difference in the bilateral pannus between rheumatoid arthritis and undifferentiated spondyloarthropathy （X^2 = 94. 192, P 〈 0.001 ）, between rheumatoid arthritis and seronegative spondyloarthropathy（x^2 = 70. 354,

关 键 词：关节炎 磁共振成像 腕关节 临床研究 

分 类 号：R445.2[医药卫生—影像医学与核医学]