超声和MRI在类风湿性关节炎腕关节病变的对比研究

Comparative Study on the Application of Ultrasonography and Magnetic Resonance Imaging in Diagnosis of Patients with Wrist Rheumatoid Arthritis

目的探讨类风湿关节炎患者腕关节病变的超声与磁共振(MRI)两种检查方法对腕关节病变的诊断效力。方法对40例诊断为类风湿关节炎患者根据病程分为早期组与晚期组,行腕关节超声和MRI检查,计算两种影像学方法对腕关节滑膜炎、关节积液、骨质侵蚀,肌腱腱鞘病变的检出率,比较二者对腕关节病变的诊断效力。结果超声和MRI在滑膜炎、关节积液的诊断,差异没有统计学意义(P>0.05),超声对肌腱炎的诊断优于MRI(P<0.05),而MRI诊断骨侵蚀优于超声(P<0.05),且能显示骨髓水肿。结论超声能较好评估腕关节滑膜炎、关节积液、骨侵蚀、肌腱腱鞘炎等病变,与MRI具有等同的诊断价值,可以作为类风湿关节炎诊断的评价方法。

Objective To explore the effectiveness of application of US（Ultrasonography） and MRI（Magnetic Resonance Imaging） in diagnosis of patients with wrist RA（Rheumatoid Arthritis）. Methods 40 patients with RA were divided into two groups（Early Group and Late Group） according to the course of disease. All patients with wrist RA were scanned by using US and MRI so as to calculate the detection rates of two examination methods in detection of wrist joint synovitis, joint effusion, bone erosion and tendinitis. The effectiveness of application of two methods in diagnosis of the wrist lesions was compared. Results US and MRI showed no statistically significant difference in diagnosis of synovitis and joint effusion of two groups（P〉0.05）. US was superior to MRI in detection of tendinitis lesions, while MRI was better than US in detection of bone erosion（P〈0.05） and was able to detect BME（Bone Marrow Edema）. Conclusion US could better assess the wrist joint synovitis, joint effusion, bone erosion, tendinitis and other lesions, which has the equal effectiveness to MRI in diagnosis of RA and should be used as an evaluation method for the diagnosis of RA.