重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2014年
7期
809-811,815
,共4页
腕关节%关节炎 ,类风湿%超声检查 ,多普勒 ,彩色%诊断
腕關節%關節炎 ,類風濕%超聲檢查 ,多普勒 ,綵色%診斷
완관절%관절염 ,류풍습%초성검사 ,다보륵 ,채색%진단
carpal joints%arthritis,rheumatoid%ultrasonography,doppler,color%diagnosis
目的:探讨高频超声影像学在类风湿性关节炎(R A )腕关节病变中的诊断价值。方法对内蒙古医科大学附属医院2012年6~12月收治的78例RA患者(RA组)腕关节采用彩色超声诊断仪检测,对照同期50例健康体检人群(健康对照组),观察记录各解剖结构的声像图表现及双侧腕关节滑膜的厚度;应用彩色多普勒血流显像及彩色多普勒能量图技术检测关节滑膜的血流特点:滑膜动脉阻力指数(RI)及搏动指数(PI),按Alde半定量法将滑膜血流丰富程度分为0~3级并探讨其与RI及PI的相关性,观察高频超声对RA腕关节早期病变的临床诊断价值。结果(1)超声显示RA组腕关节存在关节积液(65例,122个)、周围炎性渗出(34例,70个)、滑膜增生(78例,153个)、血管翳(37例,69个)及关节面不规则骨质侵蚀(29例,58个)。RA组腕关节滑膜厚度(3.50±1.37)m m ,健康对照组腕关节滑膜厚度(1.46±0.32)m m ,两组比较差异有统计学意义( P<0.05)。(2)64例关节滑膜可探及血流信号,其中RI随着血流分级的增加而逐级减低,与血流分级呈负相关( r=-0.79,P<0.05);PI随血流分级增加变化不大,二者无相关性;(3)与血清类风湿因子(RF)水平及X线片检查相比,超声检查对RA的检出率更高,差异有统计学意义(P<0.05)。结论手腕部超声检查能较好地显示RA患者的病理改变,较血清RF水平检测和X线片检测更为敏感,可以提高临床RA患者病变检出率,促进其早期诊断及合理治疗。
目的:探討高頻超聲影像學在類風濕性關節炎(R A )腕關節病變中的診斷價值。方法對內矇古醫科大學附屬醫院2012年6~12月收治的78例RA患者(RA組)腕關節採用綵色超聲診斷儀檢測,對照同期50例健康體檢人群(健康對照組),觀察記錄各解剖結構的聲像圖錶現及雙側腕關節滑膜的厚度;應用綵色多普勒血流顯像及綵色多普勒能量圖技術檢測關節滑膜的血流特點:滑膜動脈阻力指數(RI)及搏動指數(PI),按Alde半定量法將滑膜血流豐富程度分為0~3級併探討其與RI及PI的相關性,觀察高頻超聲對RA腕關節早期病變的臨床診斷價值。結果(1)超聲顯示RA組腕關節存在關節積液(65例,122箇)、週圍炎性滲齣(34例,70箇)、滑膜增生(78例,153箇)、血管翳(37例,69箇)及關節麵不規則骨質侵蝕(29例,58箇)。RA組腕關節滑膜厚度(3.50±1.37)m m ,健康對照組腕關節滑膜厚度(1.46±0.32)m m ,兩組比較差異有統計學意義( P<0.05)。(2)64例關節滑膜可探及血流信號,其中RI隨著血流分級的增加而逐級減低,與血流分級呈負相關( r=-0.79,P<0.05);PI隨血流分級增加變化不大,二者無相關性;(3)與血清類風濕因子(RF)水平及X線片檢查相比,超聲檢查對RA的檢齣率更高,差異有統計學意義(P<0.05)。結論手腕部超聲檢查能較好地顯示RA患者的病理改變,較血清RF水平檢測和X線片檢測更為敏感,可以提高臨床RA患者病變檢齣率,促進其早期診斷及閤理治療。
목적:탐토고빈초성영상학재류풍습성관절염(R A )완관절병변중적진단개치。방법대내몽고의과대학부속의원2012년6~12월수치적78례RA환자(RA조)완관절채용채색초성진단의검측,대조동기50례건강체검인군(건강대조조),관찰기록각해부결구적성상도표현급쌍측완관절활막적후도;응용채색다보륵혈류현상급채색다보륵능량도기술검측관절활막적혈류특점:활막동맥조력지수(RI)급박동지수(PI),안Alde반정량법장활막혈류봉부정도분위0~3급병탐토기여RI급PI적상관성,관찰고빈초성대RA완관절조기병변적림상진단개치。결과(1)초성현시RA조완관절존재관절적액(65례,122개)、주위염성삼출(34례,70개)、활막증생(78례,153개)、혈관예(37례,69개)급관절면불규칙골질침식(29례,58개)。RA조완관절활막후도(3.50±1.37)m m ,건강대조조완관절활막후도(1.46±0.32)m m ,량조비교차이유통계학의의( P<0.05)。(2)64례관절활막가탐급혈류신호,기중RI수착혈류분급적증가이축급감저,여혈류분급정부상관( r=-0.79,P<0.05);PI수혈류분급증가변화불대,이자무상관성;(3)여혈청류풍습인자(RF)수평급X선편검사상비,초성검사대RA적검출솔경고,차이유통계학의의(P<0.05)。결론수완부초성검사능교호지현시RA환자적병리개변,교혈청RF수평검측화X선편검측경위민감,가이제고림상RA환자병변검출솔,촉진기조기진단급합리치료。
Objective Toexploretheclinicaldiagnosisvalueofthehighfrequencycolordopplerultrasound(HFCDU)character-istiesofwristdamageinpatientswithrheumatoidarthritis(RA).Methods 78patientswithRA(RAgroup)werecollectedfrom June 2012 to December 2012 in the Affiliated Hospital of Inner Mongolia Medical University ,sonogram anatomy changes and syno-vial thickness of bilateral wrist were measured using colorul trasound ,meanwhile the respective data obtained from 50 healthy peo-ple undergoing physical examination(healthy control group);using color doppler flow imaging and color doppler energy ,synovial blood flow of artery resistance index (RI) and pulse index(PI) in synovial were measured and detected according to semi-quantitative method of alder ,and explord the correlations between RI and PI .Results (1)Among the 78 cases(156 joints) with RA ,join thy-drops(65 cases ,122 joints) ,inflammatory exudation(34 cases ,70 joints) ,synovium proliferation(78 cases ,153 joints) ,pannus(37 cases ,69 joints) and bony erosion(29 cases ,58 joints) were found.The thickness of synovial membrane of wrist in RA group was (3 .50 ± 1 .37)mm ,that in healthy control group was(1 .46 ± 0 .32)mm ,the different was statistically significant(P<0 .05) .(2) 64 cases among the 78 patients with RA were detected blood flow signals ,RI progressively reduced with blood flow grade the increas-ion which there was a negative correlation (r= -0 .79 ,P<0 .05);there was no significant correlation between PI and blood flow grade .(3) Ultrasound examination was more sensitive than rheumatoid factor (RF) and X-ray in detection rate of RA (P<0 .05) . Conclusion Ultrasound examination could detecte the pathological changes of wrist in patients with RA which is more sensitive than RF and X-ray ,and it could improve the detection rate of RA which contribute to early diagnosis and reasonable treatment for RA .