MRI和肌骨超声检查对类风湿性指关节炎疾病检查的比较研究

Comparison of MRI and musculoskeletal Ultrasonography in the Detection of rheumatoid Arthritis

目的探讨类风湿性指关节炎采用MRI和肌骨超声检查的临床效果以及对其炎性病变、病理特征的评价效果。方法选择2017年2月至2019年2月本院收治的类风湿性指关节炎患者55例(手指关节共410个),分别采取MRI检查、肌骨超声检查,对比两种检查方法的应用情况。结果两种检查方法对骨侵蚀、滑膜增生的检出情况无显著统计学差异(P>0.05);MRI对关节积液的检出率为45.12%,肌骨超声对关节积液的检出率为55.61%,肌骨超声检出率显著高于MRI(P<0.05)。滑膜厚度Ⅰ级~Ⅱ级、Ⅲ级、Ⅳ级患者的类风湿因子、红细胞沉降率和超敏C-反应蛋白水平比较无显著差异(P>0.05);MRI检查滑膜厚度明显高于超声检查,具有统计学意义(P<0.05);0级~Ⅰ级、Ⅰ级、Ⅲ级滑膜血流信号的患者类风湿因子、红细胞沉降率和超敏C-反应蛋白水平比较,有统计学差异(P<0.05)。结论肌骨超声应用于类风湿性指关节炎患者的检查中,能够有效评估患者的病理特征,其诊断价值和MRI相近,但在特定指标上具有更好效果。另外,肌骨超声还能通过滑膜厚度、血流信号、滑膜内动脉阻力指标反映患者的炎性疾病情况,这对于评价患者病情并制定治疗方案具有重要价值。

Objective To investigate the clinical effect of MRI and ultrasound examination on rheumatoid finger arthritis(RA)and to evaluate its inflammatory and pathological features.Methods From February 2017 to February 2019,55 patients(410 finger joints)with rheumatoid arthritis were selected and examined by MRI and musculoskeletal ultrasonography,the application of the two methods was compared.Results There was no significant difference in the detection of bone erosion and synovium hyperplasia between the two methods(P>0.05),the detection rate of joint effusion by MRI was 45.12%,and that of joint effusion by musculoskeletal ultrasound was 55.61%,the detection rate of ultrasound was significantly higher than that of MRI(P<0.05).There was no significant difference in the level of rheumatoid factor,erythrocyte sedimentation rate and high sensitive C reactive protein between grade I,II,III and IV patients(P>0.05);MRI showed that the thickness of synovium was significantly higher than that of ultrasound(P<0.05),and the level of rheumatoid factor,erythrocyte sedimentation rate and high sensitive C reactive protein in grade 0~I,grade I and grade III synovium blood flow signal were compared,there were statistical differences(P<0.05).Conclusion Musculoskeletal ultrasound can effectively evaluate the pathological features of patients with rheumatoid arthritis.Its diagnostic value is similar to MRI,but it has better effect on specific indexes.In addition,musculoskeletal ultrasound can reflect the inflammatory disease of patients by synovium thickness,blood flow signal and resistance index of intra-synovial artery,which is of great value in evaluating the condition of patients and making treatment plan.