类风湿性关节炎膝关节滑膜及血管增殖的高频超声研究  

A study on synovial and vascular proliferation in rheumatoid knee by high frequency color Doppler ultrasonography

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]重庆第三军医大学西南医院超声科,400038 [2]重庆第三军医大学西南医院,400038

出　　处：《中华超声影像学杂志》2000年第9期553-555,共3页Chinese Journal of Ultrasonography

摘　　要：目的　探讨高频超声显示类风湿性关节炎膝关节滑膜及血管增殖病变的价值。方法　应用高频二维、彩色多普勒、能量多普勒及频谱多普勒超声技术研究了 43例类风湿性关节炎患者膝关节滑膜二维声像图、血流信号显示情况及血流动力学改变。结果　① 83个膝关节滑膜增厚 (96 .5 1% ) ,厚度 2 .2～ 17.3mm ,平均为 (5 .79± 2 .2 8)mm ,腔面毛糙不平 ,大部分可见绒毛状突起。②滑膜血管增生 ,6 8个关节滑膜内显示低速血流信号 (81.92 % ) ,显示率与滑膜厚度有关。能量多普勒 (CDE)可提高彩色多普勒血流显像 (CDFI)为 0级的滑膜内血管显示率 ,并可显示更丰富的树支状或网状血流。③频谱多普勒检测 ,动脉Vmax=(11.76± 3 .6 8)cm /s ,Vmin=(4.6 8± 1.6 2 )cm/s ,RI =0 .6 3± 0 .0 5 ,静脉平均血流速度为 (4.37± 1.0 3)cm/s。结论　高频超声是显示类风湿性关节炎膝关节滑膜病变无创性敏感方法 。Objective To evaluate the diagnostic value of high frequency Doppler ultrasonography for displaying synovial and vascular proliferation in rheumatoid knee.Methods Greyscale imaging and blood flow of the synovial membrane were studied by high frequency grey scale, color Doppler flow imaging, color Doppler energy and pulsed wave Doppler in 43 patients (86 knee joints) with rhenmatoid arthritis (RA).Results ①The thickness of the synovial membrane was increased in 83 joints ( 96.51% , 2.2 ～ 17.3 mm), the synovial membrane was furrowed and fuzzy and synovial villi were manifested in most cases. ② Low velocity mode CDFI and CDE revealed blood flow in 68 knee ( 81.92% ) in proportion to the thickness of synovial membrane. CDE increased the positive rate of blood flow display and showed much more vascular branch than CDFI did. ③Artery blood V max , V min and RI were ( 11.76 ± 3.68 )cm/s, ( 4.68 ± 1.62 )cm/s and ( 0.63 ± 0.05 ) recorded by pulsed wave Doppler. V mean of vein was ( 4.37 ± 1.03 )cm/s. Conclusions High frequency ultrasonography is a noninvasive and sensitive method to reveal fundamental pathological alteration of synovial membrane in rheumatoid knee. The synovial and vascular proliferation could be manifested accurately by high frequency grey scale and Doppler ultrasound.

关 键 词：高频超声 血管增殖 类风湿性关节炎 膝关节滑膜 

分 类 号：R445.1[医药卫生—影像医学与核医学]