彩色多普勒超声与MRI评估幼年特发性关节炎活动度的对比分析

Color Doppler ultrasound and magnetic resonance imaging in assessment of disease activity of juvenile idiopathic arthritis

目的:对比分析彩色多普勒超声与MRI评估幼年特发性关节炎(juvenile idiopathic arthritis,JIA)疾病活动度的临床应用价值。方法:收集65例JIA患儿,对146个膝关节、踝关节进行超声检查,对56个关节进行同步MRI检查,对比分析两种影像学评估不同疾病活动度的结果。结果:JIA患儿关节病变超声表现主要为关节积液、滑膜增厚、肌腱病变及骨质病变,其中关节积液在低、中、高活动度疾病中的检出率分别为61.1%、90.7%和90.3%,滑膜增厚的检出率分别为18.1%、74.4%和80.6%,且疾病活动程度越高,滑膜血流信号越丰富。MRI表现主要为关节积液、滑膜增厚、肌腱病变及骨髓水肿,其中关节积液在低、中、高活动度疾病中的检出率分别为50.0%、93.8%和100%,滑膜增厚的检出率分别为46.4%、87.5%和91.7%。超声与MRI检查结果较为一致。结论:彩色多普勒超声及MRI评价JIA关节改变可为临床评估和随访JIA疾病活动度提供影像学基础。

Objective： To evaluate the value of Color Doppler ultrasound and magnetic resonance imaging （MRI） findings in diagnosis of juvenile idiopathic arthritis （JIA） activity. Methods： A total of 146 knees or ankles in 65 JIA patients were examined by Color Doppler ultrasound, and 56 joints were examined by MRI at the same time. The ultrasonic and MRI characteristics of different disease activity were analyzed. Results： Hydrarthrosis, synovial membrane thickening, tendinopathies and bone erosions were common findings in ultrasound of JIA. Hydrarthrosis was found in 61.1%, 90.7% and 90.3% of joints in JIA with low, moderate and high disease activity. Synovial membrane thickening was seen in 18.1%, 74.4% and 80.6% in JIA with low, moderate and high disease activity. The higher disease activity had more synovial blood flow signals. MRI findings in JIA were nearly agreed with ultrasound. Hydrarthrosis was found in 50.0%, 93.8% and 100% of joints in JIA with low, moderate and high disease activity and synovial membrane thickening was found in 46.4%, 87.5% and 91.7% of joints, respectively. Conclusion： Color Doppler ultrasound and MRI could provide imaging evidence in assessment and monitoring of JIA activity.