CAJ | 학술논문

目的探讨核磁共振成像（ MRI）在膝关节类风湿关节炎中的诊断价值。方法随机选取我院2008年10月至2012年10月临床及MRI检查均高度疑为类风湿关节炎的患者106例，进一步行关节镜检查确诊，分析MRI诊断类风湿关节炎的敏感性、特异性、阳性预测值、阴性预测值、一致率和 Kappa 值。结果与关节镜金标准结果对比，MRI对诊断类风湿关节炎的病变种类包括关节积液、滑膜增厚/血管翳形成、软骨和骨侵蚀、周围软组织病变等的敏感度、特异性、阳性预测值、阴性预测值、一致率和Kappa值分别为90.91％、88.10％、66.67％、97.37％、91.51％和0.712，MRI诊断类风湿关节炎的敏感度、特异性、阳性预测值、阴性预测值、一致率和Kappa值分别为94.74％、83.91％、56.25％、98.48％、85.85％和0.687，膝关节软骨退行性变损害的MRI分级与关节镜分级的符合率为99.06％，Kappa值为0.654，两者具有高度一致性（P＜0.05）。结论 MRI诊断类风湿关节炎有较好的一致性，并可准确判断病变种类和软骨损伤的程度，对类风湿关节炎的早期诊断和指导临床治疗都有重要意义。
목적탐토핵자공진성상（ MRI）재슬관절류풍습관절염중적진단개치。방법수궤선취아원2008년10월지2012년10월림상급MRI검사균고도의위류풍습관절염적환자106례，진일보행관절경검사학진，분석MRI진단류풍습관절염적민감성、특이성、양성예측치、음성예측치、일치솔화 Kappa 치。결과여관절경금표준결과대비，MRI대진단류풍습관절염적병변충류포괄관절적액、활막증후/혈관예형성、연골화골침식、주위연조직병변등적민감도、특이성、양성예측치、음성예측치、일치솔화Kappa치분별위90.91％、88.10％、66.67％、97.37％、91.51％화0.712，MRI진단류풍습관절염적민감도、특이성、양성예측치、음성예측치、일치솔화Kappa치분별위94.74％、83.91％、56.25％、98.48％、85.85％화0.687，슬관절연골퇴행성변손해적MRI분급여관절경분급적부합솔위99.06％，Kappa치위0.654，량자구유고도일치성（P＜0.05）。결론 MRI진단류풍습관절염유교호적일치성，병가준학판단병변충류화연골손상적정도，대류풍습관절염적조기진단화지도림상치료도유중요의의。
Objective To evaluate the efficacy of MRI in the diagnosis of rheumatoid arthritis of knee . Methods 106 consecutive patients with symptoms of knee pain were scheduled for arthroscopy in two weeks undergoing MRI examination before operation .The sensitivity,specificity,accuracy and Kappa value of MRI in the diagnosis of rheumatoid arthritis were analyzed .Results Correlated with arthroscopy findings , the sensitivity, specificity,accuracy and Kappa value of MRI in the diagnosis of rheumatoid arthritis of joint fluid ,synovium thicken or pannus formation , cartilage and bone erosion , soft tissue affection was 90.91%, 88.10%, 66.67%, 97.37%, 91.51%and 0.712 respectively .The sensitivity , specificity , accuracy and Kappa value of MRI in the diagnosis of rheumatoid arthritis was 94.74%,83.91%,56.25%,98.48%,85.85% and 0.687 respectively.The accuracy of MRI diagnosis of meniscal injury grade was 99.06%,and Kappa value was 0.654(P<0.05).Conclusion MRI has good accordance with arthroscopy in detecting rheumatoid arthritis .The types of rheumatoid arthritis and degree of meniscal injury could also be accurately evaluated .MRI has important significance in early diagnosis of rheumatoid arthritis and benefit to clinical treatment .