超声诊断幼年特发性关节炎的价值

The Value of Ultrasound in Diagnosis of Juvenile Idiopathic Arthritis

目的探究肌骨超声诊断幼年特发性关节炎(juvenile idiopathic arthritis,JIA)的价值,为临床提供一定的理论参考。方法选取我院2017年1月-2018年12月收治的JIA患者65例作为研究对象。采用超声和MRI对全部患儿进行检查,分析比较超声检查的影像学特征。结果全部患儿均接受体格检查,关节无明显受累率为49.23%(32/65),关节受累率为50.77%(33/65);32例无明显关节受累患儿,肌骨超声检查后显示阳性率为87.50%(28/32),MRI检查后显示阳性率为81.25%(26/32),二者相比较差异无统计学意义(P> 0.05)。在骨侵蚀、滑膜增生、滑囊炎、腱鞘炎、肌腱炎、附着点炎、骨化等检出率方面,肌骨超声检查分别为87.50%、87.50%、91.67%、85.71%、86.67%、88.00%、92.59%,MRI检查分别为62.50%、56.25%、50.00%、50.00%、53.33%、64.00%、70.37%,肌骨超声均高于MRI,差异有统计学意义(P <0.05),上述征象均为肌骨超声检查的主要影像学特征。结论肌骨超声应用在JIA的诊断检查中效果明显,具有较高的敏感性和准确性。

Objective To explore the value of musculoskeletal ultrasound in the diagnosis of juvenile idiopathic arthritis(JIA) and provide a theoretical reference for clinical. Methods 65 JIA patients admitted to our hospital from January 2017 to December 2018 were enrolled. All children were examined by ultrasound and MRI, and the imaging features of the ultrasound examination were compared. Results All patients underwent physical examination. No significant joint involvement rate was 49.23%(32/65), and the joint involvement rate was 50.77%(33/65). 32 children without obvious joint involvement, after musculoskeletal ultrasound examination, the positive rate was 87.50%(28/32), and the positive rate was 81.25%(26/32) after MRI. There was no significant difference between them(P > 0.05). In the detection rate of bone erosion, synovial hyperplasia, bursitis, tenosynovitis, tendonitis, attachment inflammation, ossification, musculoskeletal ultrasound examination were 87.50%, 87.50%, 91.67%, 85.71%, 86.67%, 88.00%, 92.59%, respectively. MRI examination were 62.50%, 56.25%, 50.00%, 50.00%, 53.33%, 64.00%, 70.37%, and musculoskeletal ultrasound was higher than MRI, the difference was statistically significant(P < 0.05). The above signs were the main imaging features of musculoskeletal ultrasonography. Conclusion The application of musculoskeletal ultrasound in the diagnosis of JIA is effective, with high sensitivity and accuracy.