超声在膝关节骨性关节炎滑膜病变的临床应用

Clinical Application of Ultrasonography to Synovial Lesions in Osteoarthritis of Knee Joints

【目的】探讨超声、能量多普勒和彩色多普勒对膝关节骨性关节炎滑膜炎诊断的临床价值。【方法】83例 (118个膝关节 )膝关节骨性关节炎患者和 6 1例 (6 1个膝关节 )对照组均接受了临床、实验室、X线、超声和彩色多普勒以及能量多普勒的检查。【结果】①超声检出对照组和病例组在关节积液、滑膜厚度、血流信号存在显著差异 (P <0 .0 1) ;超声检测出 88.14 % (10 4 /10 8)关节积液 ,77.97% (92 /118)膝关节滑膜增厚 ,4 0 % (4 7/118)膝关节滑膜上增生血管的血流信号。②滑膜厚度与关节积液和滑膜上血管增生的程度呈显著正 相关 (P <0 .0 1)。【结论】①高频超声因可清晰地显示极少量的关节积液 ,可以作为检查关节积液非常敏感的方法 ;②能量 (彩色 )多普勒因对膝关节滑囊炎的检查既可定性又可半定量 ,所以能量 (彩色 )多普勒对诊断滑囊炎病变的程度有一定的价值。

To explore the clinical significance of ultrasonography (US), conventional color Doppler(CD) and power Doppler (PD) in the diagnosis of osteoarthritis (OA) and synovitis of knee joints.Eighty-three patients with OA of 118 knee joints and 61 healthy subjects with 61 knee joints as controls were subjected to full clinical examinations, laboratory investigations , plain radiography, US, CD and PD.①US displayed the existence of a highly significant difference in thickness of synovium between patient and control groups (P<0.01); joint effusion and hyperplasia of synovium were found in 104(88.14%) and 92(77.97%) knee joints, respectively.②.Blood flow signals from hyperplastic vessels on the thickened synovium were shown in 47 knee joints(40%) of OA patients by CD/ PD. ③A significant positive correlation was demonstrated between synovium thickness, the degree of vascularity detected by CD/PD and knee joint effusion(P<0.01).[Conclusion]①The high-frequency US can clearly show joint effusion in minimum amount and may be used as a very sensitive method for examination of knee joint effusion; ②Examination of synovitis in knee joints by CD/PD is qualitative and half-quantitative, so both may be valuable for diagnosis of its severity.