高频超声及三维血管能量成像在早期类风湿关节炎手部关节病变诊断中的应用

Application of high-frequency ultrasound and three-dimensional color power angiography in diagnosis of hand joint damage of early rheumatoid arthritis

目的探讨高频超声(HFUS)及三维血管能量成像(3D-CPA)在诊断早期类风湿性关节炎(RA)手部关节病变中的应用。方法对临床诊断为RA的30例患者双手掌指关节和近端指间关节共600处关节进行HFUS及3D-CPA检查,测量滑膜厚度和关节腔积液,检测有无肌腱病变和骨质破坏,观察血流特点,并与20名健康志愿者双侧相应关节扫查结果对比。结果 30例RA患者手部关节中,HFUS显示关节积液458处,总检出率76.33%;滑膜增厚429处,总检出率71.50%;肌腱腱鞘炎275处,总检出率45.83%;骨质侵蚀134处,总检出率22.33%。3D-CPA显示滑膜过度形成(血管翳)86处,总检出率14.33%。结论 HFUS能显示RA患者手部关节病变的各种表现,可为临床诊断提供依据。3D-CPA立体显示血管翳形成,可辅助诊断RA活动期及评价疗效。

Objective To investigate the application of high-frequency ultrasound（HFUS） and three-dimensional color power angiography（3D-CPA）in the diagnosis of hand joint damage in early rheumatoid arthritis（RA）. Methods HFUS and 3D-CPA Six were performed for 600 metacarpophalangeal and proximal interphalangeal joints from 30 patients clinically diagnosed as RA.The thickness of synovial membrane and conditions of arthroedema were measured,the damage of tendon and destruction of bone were detected,and the characteristics of blood flow were observed.Besides,the imaging findings of 20 healthy volunteers were served as controls. Results HFUS revealed that there were 458 joints（76.33%） with arthroedema,429 joints（71.50%） with thickening synovial membrane,275 joints（45.83%） with peritendinitis of tendon and 134 joints（22.33%） with bone erosion.Vascular hypergenesis（synovium pannus） was found in 86 joints（14.33%） by 3D-CPA. Conclusion HFUS can reveal various appearance of hand joint damage in RA,which can provide a reference for diagnosis.3D-CPA may have a volumetric display of synovium pannus formation,which is helpful in the diagnosis and treatment of RA.