超声联合红外热成像对膝骨性关节炎的评估  

VALUE OF ULTRASOUND COMBINED WITH INFRARED THERMAL IMAGING IN EVALUATING KNEE OSTEOARTHRITIS

作　　者：石奇琳 王琳[1] 初晓[2] 李铁山[1] 史小娟 SHI Qilin;WANG Lin;CHU Xiao;LI Tieshan;SHI Xiaojuan(Department of Rehabilitation Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266003, China)

机构地区：[1]青岛大学附属医院康复医学科,山东青岛266003 [2]青岛市市立医院药剂科

出　　处：《青岛大学学报（医学版）》2019年第2期187-191,共5页Journal of Qingdao University(Medical Sciences)

基　　金：山东省自然科学基金项目(ZR2018MH031)

摘　　要：目的了解超声联合红外热成像评估膝关节骨性关节炎疼痛及功能障碍的价值。方法膝关节骨性关节炎病人42例,采用彩色超声诊断仪检测病人软骨磨损程度,按照超声检查结果将研究对象分为轻度组(23例)和中重度组(19例)。使用视觉模拟评分(VAS)、WOMAC骨关节炎指数对受试者的疼痛和功能障碍进行评估。于就诊当天及4周后使用SP-9000医用红外热成像仪进行红外热成像检查。结果超声检测显示的膝关节软骨磨损程度与膝关节骨性关节炎的疼痛呈强相关(r=0.817,P<0.01),与WOMAC骨关节炎指数呈强相关(r=0.827,P<0.01)。膝关节髌骨温度与超声检测的软骨磨损程度呈中度相关(r=0.442,P<0.01),上内侧温度、下内侧温度与软骨磨损程度均呈弱相关(r=0.350、0.386,P<0.01);上内侧温度与疼痛及WOMAC骨关节炎指数呈中度相关(r=0.490、0.438,P<0.01);膝关节髌骨温度与疼痛、WOMAC骨关节炎指数呈中度相关(r=0.431、0.397,P<0.01);膝关节下内侧温度与疼痛、WOMAC骨关节炎指数呈弱相关(r=0.373、0.311,P<0.05)。受试当天及4周后两次膝关节红外热成像检查提示红外热成像评估膝关节的可信度和可重复性均良好(ICC范围为0.73～0.84)。结论红外热成像和超声检查在膝关节骨性关节炎评估过程中联合应用,可以一定程度上评定膝关节骨性关节炎的疼痛和功能障碍。Objective To investigate the value of musculoskeletal ultrasound combined with infrared thermal imaging in evaluating pain and dysfunction in patients with knee osteoarthritis. Methods A total of 42 patients with knee osteoarthritis were enrolled in this study. Color Doppler echocardiography was used to evaluate the degree of cartilage wear, and according to the ultrasound findings, the patients were divided into mild group with 23 patients and moderate-to-severe group with 19 patients. Vi- sual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to eva- luate pain and dysfunction in these patients. The SP-9000 medical infrared thermal imager was used for infrared thermal imaging on the day of the test and at 4 weeks after the test. Results Ultrasound showed that the degree of knee cartilage wear was strongly correlated with the pain of knee osteoarthritis ( r =0.817, P <0.01) and WOMAC ( r =0.827, P <0.01). There was a moderate correlation between patellar temperature and degree of cartilage wear on ultrasound ( r =0.442, P <0.01), and the upper medial temperature and the lower medial temperature were weakly correlated with the degree of cartilage wear on ultrasound ( r =0.350 and 0.386, P <0.01). The upper medial temperature was moderately correlated with pain ( r =0.490, P <0.01) and WOMAC ( r = 0.438, P <0.01). Patellar temperature was moderately correlated with pain and WOMAC ( r =0.431 and 0.397, P <0.01), and the lower medial temperature was weakly correlated with pain and WOMAC ( r =0.373 and 0.311, P <0.05). Infrared thermal imaging on the day of the test and at 4 weeks after the test confirmed the reliability and repeatability of infrared thermal imaging in evaluating the knee joint ( ICC =0.73-0.84). Conclusion Infrared thermal imaging combined with ultrasound can be used to assess the pain and dysfunction of knee osteoarthritis.

关 键 词：骨关节炎 膝 膝关节 温度记录法 超声检查 

分 类 号：R684.3[医药卫生—骨科学]