高频超声在类风湿性关节炎膝关节病变中的诊断价值  

Diagnositic Value of High Frequency Color Doppler Ultrasound in Knee Joint Lesion of Rheumatoid Arthritis

作　　者：雷志辉[1] 章仕军 刘欣[1] 高弦[1] 王少特[1] 

机构地区：[1]武警湖北省总队医院超声科,湖北武汉430061 [2]武警湖北省总队宜昌市支队卫生队,湖北宜昌443000

出　　处：《武汉大学学报（医学版）》2015年第6期956-959,共4页Medical Journal of Wuhan University

摘　　要：目的:探讨高频超声在类风湿性关节炎患者膝关节病变中的诊断价值。方法:选取36例类风湿性关节炎患者,另选20例健康自愿者作为对照组,两组分别行高频超声检查,观察滑膜状态(包括滑膜厚度、关节积液深度、滑膜内血流)及软骨病变。36例类风湿性关节炎患者同时行X线平片检查,其中21例另行MRI检查。同时分析36例类风湿关节炎患者滑膜状态与患者血沉(ESR)及C-反应蛋白(CRP)的相关性。结果:病变组膝关节出现不同程度的滑膜增厚、关节积液、滑膜内血流信号增多、软骨变薄及骨质破坏等表现,与健康对照组比较差异有统计学意义(P<0.05)。36例类风湿性关节炎患者(72个膝关节)均行超声及X线检查,超声对软骨病变检出率为41.7%,X线检查率为11.1%,两种检查方法比较差异有统计学意义(P<0.01)。21例患者行超声与MRI检查,超声对软骨病变的检出率为30%,MRI检出率为51%,两种方法比较差异无统计学意义(P>0.05)。滑膜厚度与CRP(r=0.40,P<0.001)及ESR(r=0.51,P<0.001),关节积液深度与CRP(r=0.46,P<0.001)及ESR(r=0.54,P<0.001)均有一定的相关性。结论:超声可以通过观察滑膜状态及软骨病变为临床诊断类风湿性关节炎膝关节病变提供一定的依据。Objective： To explore the value of high frequency color Doppler ultrasound in patients with rheumatoid arthritis （RA） of knee joint. Methods： The synovium status, including synovium thickness, degree of hydrops articuli, blood flow circumstance and articular cartilage of 36 pa- tients with RA and other so healthy volunteers were observed by high frequency color Doppler ul- trasound. Thirty-six patients with RA underwent X-ray examinations, including 21 cases also received MRI examinations. The correlation between the ultrasonic results and erythrocyte sedimentation rate （ESR）, and C-creactive protein （CRP） of knee joints of RA were analyzed. Results： The lesions of knee joint showed varying degrees of articular synovial thickening, joint effusions, cartilage thinning, bone destruction and so on. There were significant differences between these two groups （P〈0.05）. For the 36 patients with RA （72 knee articulations）, the detection rates of diseases of articular cartilage by ultrasound was 41.7%, that by X-ray examinations was 11. 1%, and there were significant differences between these two examinations （P〈 0.05）. In 21 patients undergoing both ultrasound and MRI examinations, the detection rates of diseases of articular cartilage by ultrasound and MRI were 30% and 51%, respectively, and there was no siginificant difference between these two examinations （P〉0.05）. Ultrasound visualization showed that synovium thickness had correlation with CRP （r=0.40, P〈0. 001） and ESR （r =0.51, P〈0. 001）, the width of hydrops articuli had correlation with CRP （r=0.46, P〈 0. 001） and ESR （r=01 54,P〈0. 001）. Conclusion： High-frequency color Doppler ultrasound can observe the synovium status and articular cartilage to provide the basis for diagnosis of RA.

关 键 词：超声 类风湿性关节炎 膝关节 

分 类 号：R684[医药卫生—骨科学] R445.1[医药卫生—外科学]