膝关节痛风性关节炎MRI征象及其与血尿酸水平的相关性  

MRI features of knee gouty arthritis and their correlation with serum uric acid level

作　　者：陆少范 林波淼[2] 黄裕存 揭育添 卢锦沛 LU Shaofan;LIN Bomiao;HUANG Yucun;JIE Yutian;LU Jinpei(Department of Radiology,the Fifth People's Hospital of Zhuhai,Zhuhai,Guangdong Province 519055,China;Department of Imaging Diagnosis,Zhujiang Hospital,Southern Medical University,Guangzhou 510282,China)

机构地区：[1]珠海市第五人民医院影像科,广东珠海519055 [2]南方医科大学珠江医院影像诊断科,广东广州510282

出　　处：《实用放射学杂志》2022年第6期968-971,共4页Journal of Practical Radiology

摘　　要：目的探讨膝关节痛风性关节炎(GA)MRI征象与血尿酸(SUA)水平的相关性.方法回顾性分析80例膝关节GA患者的临床资料,所有患者入院后均行膝关节MRI检查,记录其影像学特征及病灶检出率,检测SUA水平,并根据其浓度由低到高划分为4个等级,分别对应A组(420.0μmol/L<SUA≤480.0μmol/L)、B组(480.0μmol/L<SUA≤540.0μmol/L)、C组(540.0μmol/L<SUA≤600.0μmol/L)、D组(SUA>600.0μmol/L)4个亚组,记录不同亚组间骨侵蚀、骨髓水肿及痛风石等影像学特征发生率,经Spearman相关分析评估膝关节GA患者影像征象与SUA水平之间的相关性.结果80例膝关节GA的MRI影像学征象发现骨侵蚀45例(56.25%),骨髓水肿35例(43.75%),痛风石51例(63.75%),滑膜增厚56例(70.00%),软组织肿胀61例(76.25%),关节腔积液75例(93.75%);最终临床确诊病灶数目共157个,MRI检查检出率分别为85.99%;不同SUA水平组间骨侵蚀及痛风石发生率比较有统计学意义(P<0.05),骨髓水肿、滑膜增生、软组织肿胀及关节腔积液发生率比较无统计学意义(P>0.05);经Spearman相关分析,膝关节GA患者SUA水平与骨侵蚀及痛风石均具有正相关性(r=0.396,0.423,P<0.05).结论MRI在诊断膝关节GA患者关节病变具有较高检出率,其影像学特征中骨侵蚀及痛风石与SUA水平具有一定相关性.Objective To investigate the MRI features of knee gouty arthritis(GA)and their correlation with serum uric acid(SUA)level.Methods The clinical data of 80 patients with knee GA were analyzed retrospectively.All patients underwent knee MRI examination after admission,and the imaging features and detection rate of diseased joints were recorded and SUA level was detected.The patients were divided into four levels according to SUA concentration from low to high,corresponding to subgroup A(420.0μmol/L<SUA≤480.0μmol/L),subgroup B(480.0μmol/L<SUA≤540.0μmol/L),subgroup C(540.0μmol/L<<SUA≤600.0μmol/L)and subgroup D(SUA>600.0μmol/L).The incidence rates of imaging features of bone erosion,bone marrow edema and tophi were recorded among different subgroups,and Spearman correlation analysis was used to evaluate the correlation between the imaging features of knee GA patients and the SUA level.Results MRI signs of 80 cases of knee GA found that there were 45 cases(56.25%)of bone erosion,35 cases(43.75%)of bone marrow edema,51 cases(63.75%)of tophi,56 cases(70.00%)of synovial thickening,61 cases(76.25%)of soft tissue swelling and 75 cases(93.75%)of joint cavity effusion.A total of 157 joints with positive diseases were confirmed clinically,and the detection rate of MRI examination was 85.99%.There were statistically significant differences in the incidence rates of bone erosion and tophi among groups with different SUA levels(P<0.05),but there were no statistically significant differences in the incidence rates of bone marrow edema,synovial hyperplasia,soft tissue swelling and joint cavity effusion(P>0.05).Spearman.correlation analysis showed that the level of SUA of patients with knee GA was positively correlated with bone erosion and tophi(r=0.396,0.423,P<0.05).Conclusion MRI has a high detection rate in the diagnosis of joint diseases in patients with knee GA,and its imaging features of bone erosion and tophi are related to the level of SUA.

关 键 词：膝关节 痛风性关节炎 磁共振成像 血尿酸 

分 类 号：R589.7[医药卫生—内分泌] R445.2[医药卫生—内科学] R446.122[医药卫生—临床医学]