MRI、CT、X线平片检查在类风湿关节炎早期关节病变诊断中的价值探究  

The value of MRI,CT and X-ray in the early diagnosis of rheumatoid arthritis

作　　者：杜玉 陈清亮 张鹏 Du Yu;Chen Qing-liang;Zhang Peng(Department of Imaging,The Third People's Hospital of Henan Province,Zhengzhou 450000,China;Department of Interventional Radiology,The Third People's Hospital of Henan Province,Zhengzhou 450000,China)

机构地区：[1]河南省直第三人民医院影像科,河南郑州450000 [2]河南省直第三人民医放射介入科,河南郑州450000

出　　处：《四川生理科学杂志》2025年第3期520-522,共3页

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20210255)。

摘　　要：目的:探讨磁共振成像(Magnetic Resonance Imaging,MRI)、电子计算机断层扫描(Computed Tomography,CT)及X线平片检查在类风湿关节炎(Rheumatoid arthritis,RA)关节病变早期临床诊断中的应用价值。方法:回顾性收集自2019年5月至2024年2月本院收治89例RA患者为试验组,另抽取医院同期筛查RA结果正常人群87例为正常组。以关节超声检查结果为诊断金标准,比较MRI、CT及X线平片检查方法对RA患者腕关节早期病变的诊断价值;比较三种检测方法检测的滑膜厚度结果;分析MRI、CT及X线平片检查RA关节病变的影像学表现。结果:MRI检查诊断RA患者腕关节早期病变的灵敏度、特异度、准确性分别为83.15%、72.41%、78.40%,均显著高于CT检查、X线平片检查的灵敏度、特异度、准确性。89例RA患者中178个腕关节均表现出不同程度滑膜增厚,MRI检查发现滑膜厚度为3.87±1.67mm,CT检查发现滑膜厚度为3.41±1.31mm,X线平片检查发现滑膜厚度为3.01±1.01mm,MRI、CT、X线平片检查发现滑膜厚度比较,差异有统计学意义(F=17.90,P<0.05)。MRI检查滑膜受累情况(单侧个数、双侧对数)、软组织肿胀和渗出个数、关节积液个数及构成骨信号异常/骨质改变个数占比均高于CT检查、X线平片检查,差异无统计学意义(P>0.05)。结论:MRI、CT及X线平片检查对于RA关节病变均可提供全方位直观的断层图像,但MRI检查在RA关节病变早期临床诊断中的准确性更高。Objective:To evaluate the clinical value of MRI,CT and X-ray in the early diagnosis of Rheumatoid arthritis(RA).Methods:89 patients with RA admitted to our hospital from May 2019 to February 2024 were retrospectively collected as the test group,and another 87 patients with normal RA results were selected as the normal group.To compare the diagnostic value of MRI,CT and plain X-ray in the early lesions of the wrist in patients with RA,the results of joint ultrasound were used as the diagnostic gold standard.The results of synovial thickness measured by three methods were compared.The imaging findings of MRI,CT and X-ray were observed and analyzed.Results:The sensitivity,specificity and accuracy of MRI were 83.15%,72.41%and 78.40%,respectively,which were significantly higher than those of CT and plain X-ray examination.Among the 89 RA patients,178 wrist joints showed different degrees of synovial thickening.The synovial thickness was found to be 3.87±1.67 mm by MRI,3.41±1.31 mm by CT,and 3.01±1.01 mm by X-ray plain film.MRI,CT and X-ray examination showed that the difference of synovial thickness was statistically significant(F=17.90,P<0.05).The proportion of synovial involvement(unilateral number,bilateral logarithm),soft tissue swelling and exudation,joint effusion and bone signal abnormality/bone change in MRI examination was higher than that in CT examination and X-ray examination,and the difference was not statistically significant(P>0.05).Conclusion:MRI,CT and plain X-ray examination can provide comprehensive and intuitive tomography images for RA joint lesions,but MRI examination is more accurate in the early clinical diagnosis of RA joint lesions.

关 键 词：MRI CT X线平片 类风湿关节炎 关节病变 临床诊断 

分 类 号：R44[医药卫生—诊断学]