超声及核磁共振在类风湿性关节炎膝关节病变诊断中的应用比较

目的将超声检查结果与核磁共振检查结果进行比较，评估超声对类风湿性关节炎膝关节病变的临床诊断价值。方法随机选取2013#-5月至2015#-5月经筛查、诊断疑为类凤湿性关节炎的患者42例，并对其进行进一步核磁共振成像以及超声检查，比较分析两者结果的一致性。结果在诊断包括髌上囊积液、滑膜增厚、血管翳形成等类风湿性关节炎病变种类方面，MRI与超声的结果具有高度的一致性，Kappa值为0．929（P〈0．05）。以MRI结果作为比较，超声检查结果的灵敏度、特异度、阳性预测值、阴性预测值分别为98．75％、83．33％、99．37％和71．43％。除此之外，两者在诊断膝关节软骨退行性变损害时，结果同样具有较高的一致性，Kappa值为0．843（P〈0．05）。结论超声可以为类风湿性关节炎膝关节的病变性质以及病情程度提供较好的诊断评估，对于该病的早期治疗具有重要的意义。

Objective To investigate the clinic value of ultrasound （ US ） in the diagnosis of rheumatoid arthritis of knee compared with the result of magnetic resonance imaging （ MRI ） . Methods This analysis comprised 42 patients suspected of rheumatoid arthritis in our hospital from May 2013 to May 2015, all of whom were further diagnosed with MRI and ultrasound. The consistency of these two results was compared. Results In the diagnosis of arthroedema, synovium thicken, pannus formation and other lesions, the results of MRI and ultrasound had highly consistency, and the Kappa value was 0.929 （ P〈0.05 ） . Correlated with MRI, the sensitivity, specificity, positive predictive value and negative predicated value of ultrasound were 98.75%, 83.33%, 99.37% and 71.43%, respectively. In addition, the meniscal injury grade of MR/was highly consistent with that of ultrasound, and Kappa value was 0.843 （ P〈0.05 ） . Conclusion Ultrasound could provide good diagnostic assessment to the detection of pathological nature of rheumatoid arthritis and grade of meniscal injury, having important implication in early diagnosis of rheumatoid arthritis of knee.