幼年特发性关节炎累及踝关节的MRI表现及其与临床炎性指标的相关性  

MRI manifestations of juvenile idiopathic arthritis involving the ankle joint and its correlation with clinical inflammatory indicators

作　　者：苏晓然 陈琬 时胜利 郑彬 聂磊[1] SU Xiaoran;CHEN Wan;SHI Shengli;ZHENG Bin;NIE Lei(Department of Radiology,Children’s Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院放射科,河南郑州450000

出　　处：《中国中西医结合影像学杂志》2022年第1期72-75,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:总结幼年特发性关节炎(JIA)累及踝关节的MRI表现,分析其与红细胞沉降率(ESR)和C反应蛋白(CRP)的相关性。方法:回顾性分析60例(共60个踝关节)临床确诊为JIA且踝关节受累的患儿,均行MRI平扫及增强扫描。对滑膜增生、关节积液、骨髓水肿、腱鞘炎4个征象进行半定量评价,收集初诊患儿的首次ESR、CRP数据。对踝关节受累的MRI评分与实验室指标行相关性分析。结果:60例中,滑膜增生56例,关节积液54例,骨髓水肿40例,腱鞘炎10例。受累踝关节影像表现以滑膜增生和关节积液为主,骨髓水肿以跟骨、距骨受累为主。滑膜增生、关节积液、骨髓水肿、腱鞘炎的评分标准分别为0~10、0~5、0~24、0~1分。滑膜增生与关节积液评分呈明显正相关(r=0.723,P<0.001),滑膜增生和关节积液评分与ESR、CRP呈正相关(r=0.392,0.354;P=0.011,0.023);其余征象与ESR和CRP均无相关性(均P>0.05)。结论:JIA累及踝关节MRI表现为滑膜增生、关节积液、骨髓水肿、腱鞘炎,以滑膜增生、关节积液为主,ESR、CRP是临床反映病情严重程度的指标,MRI对滑膜增生和关节积液评分可间接反映病变严重程度。Objective:To summarize the MRI manifestations of juvenile idiopathic arthritis(JIA)involving the ankle joint and to analyze its correlation with laboratory examination of erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP).Methods:The laboratory examination data and MRI manifestations of 60 children with JIA who were clinically diagnosed were retrospectively analyzed.All children underwent MRI plain scan and enhanced examination(a total of 60 ankle joints).Semi-quantitative evaluation was performed from four signs of synovial hyperplasia,joint effusion,bone marrow edema and tenosynovitis,and the first ESR and CRP experimental data of newly diagnosed children were collected.Spearman correlation analysis method was used to analyze the correlation between the MRI score of ankle joint involvement and laboratory indicators.Results:Synovial hyperplasia was seen in 56 cases,joint effusion in 54 cases,bone marrow edema in 40 cases,and tenosynovitis in 10 cases.The main clinical manifestations of ankle joint involvement were synovial hyperplasia and joint effusion,and bone marrow edema was mainly involving the calcaneus and talus.The scoring standards for synovial hyperplasia,joint effusion,bone marrow edema,and tenosynovitis were 0~10,0~5,0~24,0~1 points,respectively.Synovial hyperplasia and joint effusion scores showed a significant positive correlation(r=0.723,P<0.001).Synovial hyperplasia and joint effusion scores showed a positive correlation with ESR and CRP(r=0.392,0.354,P=0.011,0.023,respectively);other signs had no correlation with ESR and CRP(P>0.05).Conclusions:MRI images of JIA involved ankle joint show synovial hyperplasia,joint effusion,bone marrow edema,tenosynovitis,mainly synovial hyperplasia and joint effusion.ESR and CRP are indicators of the severity of the clinical response,so the MRI image of synovial hyperplasia and joint effusion scores can indirectly reflect the severity of the disease.

关 键 词：关节炎 幼年型类风湿 磁共振成像 踝关节 

分 类 号：R726.8[医药卫生—儿科] R445.2[医药卫生—临床医学]