高频超声及磁共振成像对血友病骨关节病变检出率比较研究  

Value of combination of high frequency ultrasound and MRI in assessment of changes of hemophiliac arthropathy in children

作　　者：张宁宁[1] 霍爱华[1] 吕艳秋[1] 吴荣昌[1] 彭芸[1] 

机构地区：[1]首都医科大学附属北京儿童医院影像中心,北京100045

出　　处：《中国实用儿科杂志》2017年第1期51-54,共4页Chinese Journal of Practical Pediatrics

摘　　要：目的运用高频超声及磁共振成像(MRI)综合评估血友病性骨关节病关节受累情况,比较两种检查方法检出病变的一致性。方法对2015年2月至2016年7月于首都医科大学附属北京儿童医院就诊的经临床实验室检查确诊为血友病患儿17例,选取6个膝关节、6个踝关节、5个肘关节进行超声及MRI检查,由两名儿童影像科医生根据国际血友病预防治疗协作组(IPSG)评估细则,从关节积液或血肿、滑膜增厚、含铁血黄素沉积、软骨缺失、骨质破坏及关节面下囊肿形成分别观察两种检查方法检出病变的情况,并对比两种检查方法在软组织及骨软骨病变检出情况的一致性。结果两种检查方法对检出关节病变方面,对滑膜增厚、含铁血黄素沉积、软骨丢失、骨质破坏方面有较好的一致性,Kappa值分别为1.000、0.850、0.761、0.876(P<0.05);关节腔积液方面一致性中等,Kappa值为0.605(P<0.01);关节面下囊肿的检出一致性较差,Kappa值为0.261(P=0.110)。结论血友病患儿关节软组织及骨软骨病变中,除关节面下囊肿的MRI检出率优于超声外,两种检查在其他各种病理改变的检出率上有较好的一致性。Objective To discuss the value of combination of high frequency ultrasound and MRI in assessment of changes of joints involvement in children with haemophiliac arthropathy. To compare the consistency of the two methods in detecting the disease. Methods Totally 17 cases of children with hemophilia were included, and 6 knee joints, 6 an- kle joints and 5 elbow joints were performed by ultrasonic and MRI examination. According to IPSG scores, assesement , hemosidaring, cartilage loss and bone cyst was performed to get the comparison of two kinds of examination method in the detection consistency of soft tissue and osteochondral lesions. Results The two kinds of ex- amination methods for detection of joint disease has a high consistency in synovial thickening, hemosiderin deposition, cartilage loss and bone destruction;Kappa=1.000,0.850,0.761 and 0.876 （P 〈 0.05） ;in joint effusion they showed medium consistency, and kappa value was 0.605 （P 〈 0.01 ）. Detection consistency in joint cyst was poor, and Kappa value was 0.261 （P = 0.110）. Conclusion On the detection of soft tissues and osteochondral joint changes of hemophilia in children, ultrasound and magnetic resonance imaging have poor consistency in the bone cyst, while in the detection of other pathological changes, two kinds of examination have high consistency in detection rate.

关 键 词：磁共振成像 超声 骨关节病 血友病 

分 类 号：R72[医药卫生—儿科]