儿童早期特发性关节炎的MRI表现

MRI manifestations in the early phase of juvenile idiopathic arthritis

目的:分析25例青少年特发性关节炎患者的早期MRI表现,提高对青少年特发性关节炎的早期诊断水平。方法:回顾性分析经临床、实验室检查和影像学检查确诊的25例青少年特发性关节炎(JIA)患者的早期MRI表现。结果:25例中双膝关节受累5例,单侧膝关节受累10例,双髋关节受累1例、双侧骶髂关节受累1例,双膝关节、双髋关节及双侧骶髂关节同时受累2例,双腕关节受累2例,单侧踝关节及趾间关节受累4例。主要影像学表现包括关节滑膜增厚(膝关节12个、腕关节2例4个、踝关节2个、骶髂关节1例2个),关节腔及滑囊积液(膝关节23个、髋关节6个、腕关节4个、踝关节3个),关节面下骨髓水肿(膝关节16个、髋关节6个、骶髂关节6个、腕关节4个、踝关节2个),肌腱、韧带附着点骨髓水肿(膝关节8个、髋关节6个、骶髂关节4个、腕关节2个、踝关节3个),腱鞘炎(膝关节10个、腕关节2个、踝关节1个)。结论:MRI检查对青少年特发性关节炎的诊断敏感性高,于疾病早期即可显示关节滑膜炎、肌腱炎、附着点炎及骨髓水肿,对本病的早期诊断有重要作用。

Objective：To analyze the MR images of twenty five patients with early phase juvenile idiopathic arthritis （JIA）, to improve the knowledge of early diagnoses. Methods：The clinical, laboratorial and MRI findings of 25 patients with early phase JIA were analyzed retrospectively. All patients underwent plain MR scanning. Results： Of the 25 patients with JIA,the invaded joints included bilateral knee joints （5 cases）, unilateral knee joint （10 cases）, bilateral hip and bilateral sacroiliac joints for 1 case each,bilateral knee,bilateral hip and bilateral sacroiliac joints （2 cases）, bilateral wrist joints （2 cases）, unilateral ankle and interphalangeal joints of foot （ 4 cases）. The major MRI features included thickening of synovial membrane,effusion of articular cavity and bursa, bone marrow oedema beneath articular surface and attachment of tendon and ligaments,as well as tenosynovitis. Conclusion： MRI was sensitive in the diagnosis of JIA, synovitis, tenosynovits, en-thesitis and bone marrow oedema could be depicted in the early phase, which were helpful for the early diagnosis of this disease entity.