高频彩色多普勒超声与MRI在早期类风湿关节炎诊断中的价值

目的探讨高频彩色多普勒超声（HFUS）及MRI在早期类风湿关节炎（RA）患者关节病变检测中的应用价值。方法回顾性分析2010年1-12月在山东烟台毓璜顶医院确诊的39例RA患者的临床资料，男20例，女19例，平均年龄（51．8±2．2）岁。所有患者双手、双腕均行HFUS、MR检查，重点观察有无骨侵蚀、骨髓水肿、滑膜增殖、滑膜血流、关节积液、肌腱炎等影像表现，并对两种检查方法的结果采用χ^2检验进行对比分析。结果共检查关节1248个，HFUS和MRI在观察骨侵蚀5．1％（44／858） vs 4．1％（35／858），χ^2=1．075，P〉0．05]、肌腱炎4．6％（18／390） vs 1．5％（14／390），χ^2=0．521，P〉0．05]、腱鞘水肿9．5％（37／390） vs 7．7％（30／390），χ^2=0．800，P〉0．05]方面的检出率差异无统计学意义；HFUS在观察关节滑膜增殖15．4％（132／858） vs 7．7％（66／858），χ^2=24．870，P〈0．01]、关节积液10．4％（89／858） vs 6．1％（52／858），χ^2=10．578，P〈0．05]方面明显的检出率优于MRI；MRI在观察骨髓水肿方面0％（0／858） vs 5．5％（47／858），χ^2=48．324，P〈0．05]优于HFUS。结论HFUS在检测早期RA患者病变关节的骨侵蚀、肌腱炎、腱鞘水肿、滑膜增殖、关节积液等方面，与MRI具有等同、甚至更优异的诊断价值。

Value of high frequency ultrasonography and nucler magnetic resonance imaging in the early diagnosis of rheumatoid arthritis

Objective To investigate the value of high frequency uhrasonography （HFUS） and nucler magnetic resonance imaging （MRI） in the early diagnosis of rheumatoid arthritis（RA）. Methods The data of 39 consecutive patients with RA admitted in Yantai Yuhuangding hospital from January 2010 to December 2010 were retrospectively studied. In 39 cases of patients, males were 20 cases, female were 19 cases; the average age was （51.8 ±2.2） years. Bilateral bilateral wrist and hands jionts were examined by HFUS and MRI. Bone erosion, bone marrow edema, synovial proliferation, synovial blood flow, jiont effusion and tendinitis were received and the differences between the two examination results were compared. Chi-square test was used for statistical analysis. Results All of the 1 248 joints were examined. There were no differences between HFUS and MRI in bone erosion 5.1% （44/858） vs 4.1% （35/858） , χ^2 = 1. 075, P 〉 0. 05 ], tendinitis 4.6% （18/390） vs 1.5 % （ 14/390 ）, χ^2 = 0. 521, P 〉 0.05 ], tendon sheath edema 9.5 % （37/390） vs 7.7% （30/390）, χ^2 = 0. 800, P 〉 0. 05 ]. HFUS was better than MRI in Synovial proliferation 15.4% （132/858） vs 7.7% （66/858）, χ^2 =24. 870, P 〈0.05], joint effusion 10.4% （89/858） vs 6. 1% （52/858） , χ^2 = 10. 578, P 〈 0.05 ]. MRI was better than HFUS in bone marrow edema 0% （0/858） vs 5.5% （47/858）, χ^2 =48.324, P〈0.05]. Condusions HFUS is equivalent or better than MRI in bone erosion, tendinitis, tendon sheath edema and synovial proliferation.