彩色多普勒超声对类风湿关节炎腕关节、手部关节病变的诊断价值

Diagnostic value of color Doppler ultrasound in wrist joints,and hand-articular lesions in patients with rheumatoid arthritis

目的探讨彩色多普勒在类风湿关节炎(RA)腕关节、手部关节病变中的诊断价值。方法选择健康对照组30例,RA病人40例,应用彩色多普勒超声检测对比观察腕关节、掌指关节、指间关节、近端指间关节滑膜的厚度,血流供应、骨面及软组织情况。结果RA组共检查出73%腕关节滑膜增生,11%手部关节滑膜增生,89%腕关节及29%的手部关节增生的滑膜内见血管过度增生。病变关节数的10%见软骨下骨侵蚀。结论彩色多普勒超声能够显示RA病变关节的滑膜炎症,血管翳形成,软骨下骨侵蚀等病理改变,由于其无辐射、易重复的特点,是诊断RA病人腕关节、手部关节病变的首选方法之一。

Objective To evaluate the diagnostic value of color Doppler ultrasound in wrist joints,and hand-articular lesions in patients with rheumatoid arthritis（RA）.Methods Wrists,metacarpophalangeal joints and inter-phalangeal joints,proximal phalangeal joints in 70 cases were examined by color Doppler ultrasound,including 30 cases of healthy control group and 40 cases of RA.The thickness of synovial joints,blood supply,bone face and soft tissue situation were measured.Results Synovial hyperplasia in vascular hyperplasia was found in 73% of the wrist joint synovialhyperplasia,and 11% hand synovial hyperplasia,89% and 29% of wrist hand joint,respectively.10% joints of RA patients showed articular sub-chondral bone erosion.Conclusion Color Doppler ultrasound can show the joints of RA synovitis lesions,pannus formation,erosion of subchondral bone and other pathological changes.Color Doppler ultrasound is an effective diagnosis method for lesions in wrist,and hand joints in patients with RA.