早期类风湿关节炎腕关节MRI与临床对照研究  

MRI findings of wrist in early rheumatoid arthritis:comparison with clinical features

作　　者：郭智萍[1] 赵建[1] 李石玲[1] 王金凯[2] 孙英彩[1] 赵振江[1] 

机构地区：[1]河北医科大学第三医院CT/MR室,河北石家庄050051 [2]河北医科大学第三医院血液科,河北石家庄050051

出　　处：《中国医学影像技术》2007年第7期1072-1075,共4页Chinese Journal of Medical Imaging Technology

基　　金：河北省科技厅科技攻关项目基金资助(06276102D-89)

摘　　要：目的探讨腕关节早期类风湿关节炎(RA)的各种主要MRI表现及临床症状、实验室检查等指标对于早期类风湿关节炎的诊断价值。方法经随访临床确诊早期RA病人78例,对确诊前研究对象的平片及MRI表现及临床症状、实验室检查指标进行分析。临床方面指标包括有晨僵、对称性关节肿胀、关节肿胀个数、血沉(ESR),类风湿因子(RF),C反应蛋白(CRP)。MRI对腕骨间关节的滑膜,骨骼,软骨,肌腱等进行观察。对照分析早期RA各种主要MRI征象及临床症状、实验室检查的准确性、特异性及敏感性。结果敏感性最高的MRI指标血管翳强化与晨僵或RF阳性同时存在时,特异性及准确性均较高。结论MRI血管翳强化与晨僵或类风湿因子阳性同时存在时,对于诊断早期类风湿关节炎具有较大的价值。Objective To study the appearances of the wrist of early stage rheumatoid arthritis （RA） in MRI, and to evaluate the value of MRI and clinical symptom and laboratory test in diagnosis of early RA. Methods Seventy-eight patients with clinical diagnosed RA were selected, 29 male, 49 female; age range, 19-78 years. All the patients underwent radiography and pre-contrast and post-contrast MR examination. Clinical and laboratory examinations included.- morning stiffness, symmetric swelling joints, three or more swelling joints, serum rheumatoid factor （RF）, erythrocyte sedimentation rate （ESR）, c-reaction protein （CRP） were counted. MRI appearance of synovium, bone, cartilage and tendons of wrist joints and so on were observed. The accuracy, specificity and sensitivity of MR scan, clinical features and laboratory test were analyzed in diagnosis of early stage RA. Results The specificity and accuracy were high, when pannus enhancement and morning stiffness or pannus enhancement and RF positive existed simultaneity. Conclusion It has great value to diagnose RA when pannus enhancement in MRI existed simultaneity with morning stiffness or and RF positive.

关 键 词：关节炎 类风湿 磁共振成像 腕关节 

分 类 号：R445.20[医药卫生—影像医学与核医学] R593.21[医药卫生—诊断学]