类风湿腕关节炎磁共振成像与临床症状及实验室检查结果的相关性研究  

Correlation between the magnetic resonance imaging findings of the wrist in rheumatoid arthritis and the clinical symptoms and laboratory results

作　　者：李韧[1] 王冀[1] 刘勇[1] 

机构地区：[1]成都市第一人民医院放射科,四川成都610041

出　　处：《现代医学》2016年第2期161-167,共7页Modern Medical Journal

摘　　要：目的:分析类风湿腕关节炎磁共振成像(MRI)结果与临床症状及实验室检查结果的相关性。方法:回顾性分析我院收治的54例类风湿腕关节炎采用MRI扫描双腕关节病人的资料,同时选取20例正常志愿者作为对照,对比分析患者的临床症状、生命体征、实验室检查结果与MRI结果的相关性。结果:所有患者均发现滑膜变厚、血管翳增生(其中42例患者的血管翳呈增强表现),23例有骨髓水肿,39例出现关节积液,38例发生骨质破坏。前3类患者分别与无相应临床症状的患者从整体评估、健康评估、红细胞的沉降率及关节肿胀数等方面进行比较,差异均具有统计学意义(P<0.05)。骨髓水肿与无骨髓水肿的患者跖趾关节压痛、骨质破坏、抗核周因子等方面比较,差异均有统计学意义(P<0.05)。结论:MRI技术可显示出类风湿关节炎的病理学变化,其对类风湿腕关节炎的诊断及预后评价具有重要的临床价值。Objective： To study the correlation between the magnetic resonance imaging findings of the wrist in rheumatoid arthritis and the clinical symptoms and laboratory results. Methods： The clinical data of 54 patients with rheumatoid arthritis wrist in our hospital were retrospectively analyzed,and their wrist joints were scanned using1. 5 T MRI scanner. Twenty healthy volunteers were served as normal controls. The clinical symptoms,vital signs,laboratory results and the magnetic resonance imaging findings of the patients were analyzed and compared with those of the normal controls. Results： The synovial thickening and pannus hyperplasia were found in all the patients,including 42 patients showing enhanced pannus. There were 23 cases of bone marrow edema,38 of bone destruction and 39 of joint effusion. The patients with the symptoms of panus,bone marrow dedema and joint effusion were compared with those without the symptoms with respect to overall assessment,health assessment,erythrocyte sedimentation rate and the joint swelling index. The difference was statistically significant（ P〈 0. 05）.Comparison of plantar toe joint tenderness,bone destruction and anti-perinuclear factor between the patients with bone marrow edema and patients without bone marrow edema showed statistically significant difference（ P〈 0. 05）.Conclusion： Magnetic resonance imaging can show pathological changes in rheumatoid arthritis,and is useful for the diagnosis and prognostic assessment of rheumatoid arthritis wrist.

关 键 词：类风湿关节炎 磁共振成像 临床症状 实验室检查 

分 类 号：R593.22[医药卫生—内科学] R445.2[医药卫生—临床医学]