类风湿性膝关节炎放射性滑膜切除治疗后血管翳变化的能量多普勒研究

Power Doppler sonography in assessment of synovial pannus of rheumatoid knee after ^(32)P radiation synovectomy

目的 研究类风湿性膝关节炎3 2 P放射性滑膜切除治疗血管翳的高频能量多普勒改变并探讨其作为疗效判定客观指标的价值。方法 用高频超声能量多普勒观察 5 3例患者治疗前及治疗后 6～ 12个月膝关节滑膜血管翳血流信号改变并进行半定量分析。结果 治疗前膝关节滑膜血管翳血流信号显示 43例 ( 81.13 % ) ,其中Ⅰ级 14例 ,Ⅱ级 19例 ,Ⅲ级10例。治疗后 6～ 12个月 ,滑膜血流显示 15例 ( 2 8.3 0 % ) ,较治疗前显著减少 (P <0 .0 1) ,且Ⅱ级和Ⅲ级血流信号消失。结论 高频超声能量多普勒能够敏感地显示类风湿性膝关节炎放射性滑膜切除后血管翳改变 。

Objective To study the power Doppler sonographic changes of synovial pannus of rheumatoid knee after radiation synovectomy, and to explore its value in objective assessment of treatment efficacy. Methods High frequency power Doppler sonography was performed in 52 patients with rheumatoid knee before and 6-12 months after 32 P intra articular injection. Synovial pannus vascularity was classified semiquantitatively. Results Power Doppler revealed blood flow in 43 patients (81.13%) before treatment, including 14 cases in grade Ⅰ, 19 in grade Ⅱ and 10 in grade Ⅲ. 6-12 months after treatment, pannus blood flow was revealed in 15 patients (28.30%), grade Ⅱ and grade Ⅲ blood flow pattern disappeared, showing a significant reduction in pannus vascularigation ( P <0.01). Conclusion High frequency power Doppler could manifest the changes of pannus vascularity accurately and sensitively in rheumatoid knee joints after radiation synovectomy. It may be a valuable method in the assessment of RA activity and in monitoring the therapeutic responses objectively.