血友病性关节病MRI滑膜体积测量评估放射性滑膜切除术疗效的价值  

The clinical values of synovial volume measurement by MRI in patients with hemophilic arthropath receiving 32p radiation synovectomy

作　　者：窦银聪 李美霞[2] 张璐 程天明 雷平冲[3] 葛英辉 Dou Yincong, Li Meixia, Zhang Lu, Cheng Tianming, Lei Pingchongo C,e Yinghui(Department of Radiology, Henan Provincial People＇s Hospital, Zhengzhou University People＇s Hospital, Zhengzhou 450003, Chin)

机构地区：[1]郑州大学人民医院河南省人民医院放射科,450003 [2]新乡医学院第一附属医院放射科 [3]河南省人民医院暨河南省血友病诊疗中心

出　　处：《中华放射学杂志》2018年第4期291-294,共4页Chinese Journal of Radiology

基　　金：国家自然科学基金（81271543）

摘　　要：目的探讨血友病性关节病（HA）患者滑膜体积测量对放射性滑膜切除术疗效评估的价值。方法本研究为前瞻性，研究对象选取2011年5月至2015年1月在河南省人民医院血友病诊疗管理中心就诊或住院治疗的HA患者共42例，病变关节63个。63个关节同时进行MRI非增强及增强扫描，其中16例（21个关节）进行32P放射性滑膜切除术前后的对比研究。用后处理工作站进行滑膜体积测量。采用两样本配对t检验对同一关节的非增强和增强滑膜体积、治疗前后滑膜体积及强化幅度比值进行比较。结果HA患者MRI增强前后滑膜体积测量差异无统计学意义。治疗后滑膜体积（2 479.45±46.48）mm^3较治疗前（2 983.30±42.87）mm^3明显缩小（t=7.831，P=0.000），治疗后滑膜强化幅度比值（0.92±0.06）较治疗前（1.17±0.07）明显减低（t=2.108，P=0.048）。结论HA患者的关节滑膜体积和强化幅度比值的变化是评估放射性滑膜切除术疗效的重要指标。Objective To investigate the clinical value of eynovial membrane volume measurement by MRI in patients with hemophilic arthropathy receiving radionuclide synoviectomy.Methods Forty two patients, total 63 diseased joint, who hospitalized in the hemophilia diagnosis and treatment center of Henan Province People＇s Hospital were enrolled in the study after receiving both enhanced an non enhanded MRI, from May 2011 to January 2015. Sixteen patients （21 joints） were treated with 32P radionuclide synoviectomy （PRS） and followed up. The synovial membrane volume were evaluated by enhanced and non enhanded MRI before and after PRS. All data were analyzed by t test.ResultsThe synovial membrane volume had no statistical difference by using the non enhanced （3 104.38±60.19）mm^3 and enhanced （2 995.19±59.14）mm^3 MRI scans （t=-1.369, P=0.191）. The synovial membrane volume post PRS （2 479.45±46.48）mm^3 much lower than that before PRS （2 983.30±42.87） mm^3 （t=7.831, P=0.000）. The magnetic resonance enhanced range after PRS （0.92±0.06） was significantly lower than that before treatment （1.17±0.07） （t=2.108, P=0.048）.ConclusionSynovial membrane volume and magnetic resonance enhanced range are important index to predict clinical efficacy of PRS.

关 键 词：血友病 骨关节病 继发肥大性 治疗结果 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R554.1[医药卫生—诊断学]