磁共振成像在类风湿关节炎患者膝关节病变研究中的意义

MR Imaging of the knee in rheumatoid arthritis

目的 初步探讨磁共振成像 (MRI)技术在类风湿关节炎 (RA)患者膝关节病变临床诊断中的应用价值。方法 对 2 0例RA患者的 34个膝关节进行多种序列成像并分析其MRI表现。结果 MRI可清晰显示RA膝关节的滑膜增生及血管翳形成、关节软骨破坏、骨质受侵、关节囊积液、半月板及韧带异常、窝囊肿形成以及皮下结节等改变 ,并能通过血管翳的信号和强化程度判断疾病是否处于活动期。结论 与X线相比 ,MRI对RA的骨质侵蚀破坏更为敏感 (P <0 0 1)。MRI能直接显示RA患者膝关节不同时期的各种改变 。

Objective To assess the diagnostic value of MR imaging of the knee in patients with rheumatoid arthritis.Methods MR imaging was performed on 34 knees in 20 patients by using unenhanced T1 weighted spin echo,T2 weighted turbo spin echo,fat suppressed 3D fast gradient echo and enhanced T1 weighted spin echo sequence.All MRI manifestations of the 34 knees were reviewed.Results All changes including synovial hyperplasia,pannus formation,articular cartilage destruction,bone erosion,joint effusion,meniscus and ligament lesion,popliteal cysts and subcutaneous nodule formation were depicted clearly by MR imaging.Also the signal intensity of the pannus before and after the injection of contrast agent were proved to be valuable for determination of activity of disease.Conclusion MRI is proved to be more sensitive to bone erosion in RA than X ray( P <0 01).Various lesions in various stages of rheumatoid arthritis could be demonstrated directly by MR imaging.MRI is proved to be a valuable technique for early diagnosis and staging of rheumatoid arthritis.