超声造影在风湿性关节炎滑膜增生程度活动度中的判断效果及价值研究

Contrast-enhanced ultrasound in rheumatoid arthritis synovial hyperplasia of judgment effect and value of the degree of mobility

目的探讨超声造影在风湿性关节炎滑膜增生活动度中的判断效果及价值。方法取2015年1月至2017年1月该院收治风湿性关节炎滑膜增生患者40例，设为观察组；取同期入院健康体检者40例，设为对照组。2组入院后均在髌上囊行常规高频超声及能量多普勒超声检查，选择滑膜增生最厚区域在超声下判断滑膜血流信号分级，确定活动度情况；对同一滑膜进行超声造影检查，判断其活动度，分析超声造影在风湿性关节炎滑膜增生活动度中的判断效果，以分析达峰时间、峰值强度及曲线下面积等参数，获得滑膜炎性改变程度、时间-强度曲线各参数与血生化数据间的相关性。结果观察组超声造影下滑膜厚度、液性无回声区深度，大于对照组（P〈0．05）；观察组40例患者中，PDUS模式下23例膝关节髌上囊增厚增厚滑膜中探及明显血流信号。17例未探及明显血流信号；CEUS模式下，39例在CEUS模式下均存在不同程度的增强；1例增生滑膜无明显增强（非活动性）。时间一强度曲线各参数与血生化数据间存在良好相关性（P〈O．05）。结论风湿性关节炎滑膜增生患者采用超声造影诊断效果理想，能够比较直观并且准确的判断滑膜增生程度，并可判断滑膜炎的活动性，对于RA的临床诊断及治疗时机选择具有重要价值，值得推广及应用。

Objective to study the ultrasonic imaging in rheumatoid arthritis synovial proliferation activity of judgment effect and value. Methods apply in January 2015-January 2017 hospitals 40 patients with rheumatoid arthritis synovial hyperplasia,set as observation group;Take over the same period in hospital physical examination of 40 cases,as control group. Two groups after ad- mission line on patellar sac conventional high frequency ultrasound and power doppler ultrasound examination,choose synovial hy- perplasia of the thickest area under ultrasonic judgment synovial blood flow signal classification, determine activity; On the same synovial contrast-enhanced ultrasound examination,determine its activity,analysis of contrast-enhanced ultrasound in the effective- ness of judgment in rheumatoid arthritis synovial proliferation activity. Results the observation group under the ultrasonic imaging synovial thickness, fluid anechoic zone depth,is greater than the control group（P〈0.05）;Observation group of 40 cases, 23 cases PDUS mode on the knee patellar capsule thickening of synovial thickening and obvious blood flow signal. 17 cases not agent and ob- vious blood flow signal;CEUS mode, 39 cases in CEUS mode there are varying degrees of enhancement; 1 case of hyperplasia of synovial membrane has no obvious enhancement （inactive）. Conclusion in patients with rheumatoid arthritis synovial hyperplasia using contrast-enhanced ultrasound diagnosis effect is ideal, to determine its activity, to provide reference and basis for clinical treat- ment, is worthy of popularization and application.