MRI常规序列与3D-WATS对早期RA手关节病变的诊断价值

Diagnostic Value of Conventional MRI Sequence and 3D-WATS in Early RA Cheiroarthropathy

目的探讨磁共振成像(MRI)常规序列与三维水选择成像序列(3D-WATS)对早期类风湿性关节炎(RA)手关节病变的诊断价值。方法选取2017年1月~2018年6月间收治的拟诊为早期RA的患者90例作为研究对象。评估不同序列诊断早期RA的诊断效能,比较不同序列RA早期病变检出率(关节滑膜炎、关节积液、肌腱腱鞘炎、骨侵蚀)。结果①3D-WATS序列和多序列检查灵敏度、特异度、准确率均高于常规序列(P<0.05);3D-WATS序列、多序列MRI检查特异度对比,差异无统计学意义(P>0.05);3D-WATS序列、多序列MRI检查准确率对比,差异无统计学意义(P>0.05);②常规序列、3D-WATS及多序列的关节积液、肌腱腱鞘炎、骨侵蚀检出率对比,差异无统计学意义(P>0.05);3DWATS及多序列的关节滑膜炎检出率均高于常规序列(P<0.05)。结论 MRI检出早期手关节病变中,3D-WATS序列效能优于常规序列。

Objective To explore the diagnostic value of conventional magnetic resonance imaging(MRI) sequence and three-dimensional water imaging sequence(3 D-WATS) in early rheumatoid arthritis(RA) cheiroarthropathy. Methods 90 patients with early RA who were admitted between January 2017 and June 2018 were selected for the study. The diagnostic efficiency of different sequences in the diagnosis of early RA was evaluated, and the detection rates of early RA lesions(joint synovitis, joint effusion, tenosynovitis, bone erosion) were compared between different sequences. Results The sensitivity, specificity and accuracy rate of 3 D-WATS sequence and multiple sequence examination were higher than those of conventional sequence(P<0.05). There was no statistically significant difference in the specificity between 3 D-WATS sequence and multiple sequence MRI examination(P>0.05). There was no statistically significant difference in the accuracy rate between 3 D-WATS sequence and multiple sequence MRI examination(P>0.05). There were no statistically significant differences among conventional sequence, 3 D-WATS and multiple sequence in the detection rates of joint effusion, tenosynovitis and bone erosion(P>0.05). The detection rate of joint synovitis by 3 D-WATS or multiple sequence was higher than that by conventional sequence(P<0.05). Conclusion 3 D-WATS sequence has better efficiency than conventional sequence in the detection of early cheiroarthropathy by MRI.