彩色超微血管成像技术及高频超声在早期幼年特发性关节炎膝关节病变的应用  

Application of color Superb microvascular imaging and high-frequency ultrasonography in juvenile idiopathic arthritis

作　　者：齐清华[1] 刘宏建[2] 赵艳萍[1] 吴志彬[1] 王娇娇[1] 寇红伟[2] 尚国伟[2] Qi Qinghua;Liu Hongfian;Zhao Yanping;Wu Zhibin;Wang Jiaojiao;Kou Hongwei;Shang Guowei(Department of Ultrasound,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Orthopaedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院超声影像科,450052 [2]郑州大学第一附属医院骨科,450052

出　　处：《中华实验外科杂志》2018年第12期2330-2332,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨彩色超微血管成像(cSMI)技术联合高频超声在早期活动性幼年特发性关节炎(JIA)患儿膝关节病变的应用。方法临床确诊为早期活动期JIA患儿90例,所有患儿均伴有膝关节疼痛、肿胀,应用高频超声对所有JIA患儿膝关节进行检查,观察JIA患儿膝关节病变的主要超声征象,记录滑膜增厚关节数目,统计滑膜增厚关节滑膜厚度及髌上囊积液厚度,分别用cSMI、能量多普勒(PDUS)对增厚滑膜进行血流检测,并对血流信号进行半定量评分,同时收集患儿同期的红细胞沉降率(ESR)、C-反应蛋白(CRP),比较cSMI、PDUS对增厚滑膜血流显示差异,对cSMI、PDUS血流信号评分结果、ESR、CRP、增厚滑膜、髌上囊积液进行相关分析。结果110个膝关节髌上囊显示滑膜增厚,滑膜增厚关节均伴有不同程度的髌上囊积液;增厚滑膜厚度及髌上囊积液厚度分别为(6.01±3.08)、(7.45±3.91)mm;增厚滑膜PDUS、cSMI血流显示率分别为59.09%、86.36%,两成像方式血流显示差异有统计学意义(P=0.000);膝关节增厚滑膜内PDUS与cSMI血流分级间差异有统计学意义(P=0.000),较PDUS,cSMI可上调血流分级;PDUS及cSMI血流信号分级与CRP、ESR、增厚滑膜及髌上囊积液均呈正相关(P=0.000),CRP与ESR、增厚滑膜呈正相关(P=0.000),ESR与增厚滑膜及髌上囊积液呈正相关(P=0.000),增厚滑膜与髌上囊积液呈正相关(P=0.000)。结论cSMI联合高频超声有助于诊断早期活动性JIA患儿膝关节病变。Objective To explore the application of color Super Microvascular Imaging (cSMI) and high-frequency ultrasonography (US) in evaluating the knee joint diseases of juvenile idiopathic arthritis (JIA) in the active period. Methods 90 patients diagnosed JIA clinically with knees pain and swelling were collected, the ultrasound diagnostic apparatus was used to examine knee joints. the main US signs were observed, the numbers of thickening of suprapatellar bursa synovial joints were recorded. The thickness of synovial membrane and the thickness of suprapatellar bursa effusion were also recorded, the blood flow signals of the thickening of synovial joints was checked by the cSMI and power doppler ultrasound (PDUS) separately. Color flow signals were graded by the semi-quantitative scoring systems. At the same period, the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were collected. The differences of cSMI and PDUS in thickened synovial blood flow were compared. The correlations between the parameters were analyzed. Results 110 suprapatellar bursa synovial joints showed synovial thickening, synovial thickened joints are associated with varying degrees of suprapatellar bursa effusion. The thickness of synovial membrane and the thickness of suprapatellar bursa effusion were (6.01±3.08) mm, (7.45±3.91) mm, respectively. The proportion of blood flow signals detected by cSMI in thickened synovial membranes of Wri was 86.36%, while that of PDUS was 59.09%. The differences of blood flow signals rate were statistically significant (P=0.000). The differences of grading of PDUS and cSMI were statistically significant (P=0.000), Compared with PDUS, cSMI can raise the blood flow classification level. PDUS and cSMI blood flow signals grading were positively correlated with CRP, ESR, synovial membrane and suprapatellar bursa effusion (P=0.000). CRP was positively correlated with ESR, synovial membrane and suprapatellar bursa effusion (P=0.000). Synovial membrane was positively correlated with suprapatellar bursa

关 键 词：幼年特发性关节炎 膝关节 彩色微血管成像技术 高频超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R725.9[医药卫生—诊断学]