高频超声在类风湿性膝关节炎诊断中的应用  

The Application of High frequency Ultrasonography in Diagnosis of Rheumatoid Knee

作　　者：李锐[1] 郭燕丽[1] 何晓红[1] 方勇飞[2] 柏干苹[2] 

机构地区：[1]第三军医大学西南医院超声科,重庆市400038 [2]第三军医大学西南医院,重庆市400038

出　　处：《中国超声医学杂志》2000年第7期550-552,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :探讨高频超声检查在类风湿性关节炎膝关节病变诊断中的应用价值。方法 :应用高频超声及彩色多普勒技术研究了 32例类风湿性关节炎患者 6 4个膝关节二维超声图像及彩色多普勒血流改变并与 X线检查进行比较。结果 :(1)关节囊积液 6 2个 (96 .87% ) ,间距 2 .9～ 2 5 .6 mm ;(2 ) 6 1个关节囊滑膜增厚 (95 .31% ) ;厚度 2 .2～ 16 .9mm,腔面毛糙不平 ,部分可见绒毛状突起 ;(3)滑膜血管增生 ,47个关节滑膜内显示 ,低速血流信号(73.43% ) ,多数为点状及短棒状 ,少数为树枝状血流信号 ;(4)显示关节软骨损坏 46个 (71.88% ) ,骨质侵蚀破坏39个关节 (6 0 .93% )。 X线检查报告关节肿胀 3例 (9.4% ) ,无 1例报告关节囊积液或滑膜增生改变。结论 :高频超声检查是显示类风湿性关节炎膝关节病变敏感而准确的方法 ,在显示滑膜渗出积液、滑膜增厚血管增殖及骨质早期侵蚀等方面明显优于Objective:To evaluate the diagnostic value of high frequency ultrasound in diagnosis of rheumatoid knee.Methods:Twenty three patients with 46 knee joints rheumatoid arthritis (RA) were studied with high frequecy ultrasound (HFU) and color Doppler flow imaging (CDFI). Results:(1) 62 knee joints showed synovial effusion. 2 9~25 6mm in width. (2) The synovial membrane thickness increased in 61 joints, furrowed synovial membrane and fuzzy synovial villi could be seen in some cases. (3)Low velocity mode CDFI revealed blood flow in 47 thickened synovial membrane, illustrating vascular proliferation of the synovial membrane. (4)Cartilage damage was detected in 46 joints and bone erosions in 36 knee joints. The knee joint swelling was reported in 3 patients by plain radiography. No synovial effusion or synovial proliferation was showed by x ray examination in all the 23 patients.Conclusion: HFU is a sensitive and accurate method to reveal fundamental pathological changes of rheumatoid knee, it is rather superior to radiography in detecting synovial effusion, synovial proliferation, early cartilage damage and bone erosion.

关 键 词：类风湿性关节炎 高频超声 彩色多普勒血流显像 

分 类 号：R445.1[医药卫生—影像医学与核医学]