高频彩超对类风湿关节炎腕关节病变的诊断意义  

Significance of high frequency color Doppler ultrasound in diagnosis of wrist joint lesions in patients with rheumatoid arthritis

作　　者：张文静[1] 邱少东[1] 陈菲[1] 郑洁[1] 罗燕华[1] 

机构地区：[1]广州医科大学附属第二医院医学超声科,广东广州510260

出　　处：《中国医药导报》2016年第10期23-26,共4页China Medical Herald

基　　金：广东省广州市医药卫生科技项目(20131A011153)

摘　　要：目的探讨高频彩超在类风湿关节炎（RA）腕关节病变诊断中的临床价值。方法选取2013年5月~2015年9月于广州医科大学附属第二医院（以下简称＂我院＂）收治的100例RA患者作为病例组,选取我院同期健康受检者50例作为对照组。分别行腕关节超声检查,分析两组声像图表现、腕关节滑膜厚度差异;测定并记录病例组滑膜血流分级与动脉血流阻力指数（RI）,并对病例组进行数字化X射线摄影（DR）检查,分析超声及DR对骨侵蚀检出率的差异;观察病例组治疗前和治疗3个月后滑膜厚度、血流分级及RI值变化。结果对照组灰阶超声显示关节腔未见积液,骨面或关节面光滑,骨表面出现一层低回声带且未见血流信号显示;病例组滑膜增生检出率为92.5%（185/200）,关节腔积液检出率为80.0%（80/100）,滑膜内血流信号检出率为42.0%（84/200）;病例组滑膜厚度明显大于对照组（P〈0.05）;在病程〈2年的RA患者中,与DR比较,超声检查对骨侵蚀的检出率明显较高（P〈0.05）;与治疗前比较,病例组治疗后滑膜厚度无明显变化,滑膜血流明显减少。结论超声可用于RA的诊断及治疗随访,为患者治疗前的方案制订和治疗后的效果评价提供了可靠的影像学依据。Objective To investigate the clinical value of high frequency color Doppler ultrasound in diagnosis of wrist joint lesions in patients with rheumatoid arthritis（RA）. Methods One hundred cases of patients with RA admitted to the Second Affiliated Hospital of Guangzhou Medical University（ ＂our hospital＂ for short） from May 2013 to September 2015 were selected as case group, 50 cases receiving examination in our hospital at the same time were selected as control group. All patients were given wrist joint examination. The performance of ultrasound and changes of synovial thickness of wrist joint between the two groups were analyzed; the blood flow classification of synovium and artery resistance index（RI） in the case group were detected and recorded; the case group was taken examination of digital radiography（DR）,the differences of ultrasound and DR for detection rate of bone erosion; the changes of synovial thickness, blood flow classification and RI value before treatment and after treatment for three months were observed. Results The gray scale ultrasound of control group showed that there wasn＇t effusion in articular cavity, bone surface and articular surface were smooth, and there was hypoecho band on bone surface without blood flow classification. In the case group, the detection rate of synovial hyperplasia was 92.5%（185/200）, the detection rate of joint effusion was 80.0%（80/100）, and the detection rate of blood flow classification was 42.0%（84/200）. The synovial thickness of the case group was bigger than that of control group（P 〈0.05）. During patients whose course was less than two years, compared with DR examination, the detection rate of ultrasound for bone erosion was higher（P 〈0.05）. Compared with before treatment, the patients in the case group after treatment had no significant changes in the synovial thickness, and the synovial blood flow was signifi-cantly reduced. Conclusion Ultrasound can be used in the diagnosis and treatment of RA, which provides a r

关 键 词：类风湿关节炎 腕关节 诊断 超声 

分 类 号：R593.22[医药卫生—内科学]