超声造影在类风湿关节炎腕关节炎活动期病变诊断价值研究.docVIP

超声造影在类风湿关节炎腕关节炎活动期病变诊断价值研究 　　[摘要] 目的 研究超声造影在类风湿关节炎腕关节炎活动期病变的诊断价值。 方法 选择我院风湿免疫科2014年7月～2016年6月收治的类风湿关节炎患者35例，所有患者的就诊主诉均为腕关节肿痛，均处于疾病活动期，对所有患者进行超声造影检查，测量超?造影后强化的滑膜厚度及二维超声下滑膜厚度等，对滑膜的超声造影灌注分级，并对滑膜厚度、超声造影灌注分级与DAS28、实验室指标及超声造影灌注分级与超声造影TIC等定量指标的相关性进行统计分析。 结果 超声造影后强化的滑膜厚度显著厚于二维超声下滑膜厚度（P0.05）；35个关节中，超声造影通过观察血流检测出33个活动性关节，占总数的94.3%；滑膜厚度、超声造影灌注分级与DAS28、EST、CRP均显著相关（P0.05）；滑膜厚度、超声造影灌注分级与其AUC、PI、WS均显著相关（P0.05）。 结论 超声造影对于类风湿关节炎腕关节炎活动期病变的诊断具有较高的价值。 　　[关键词] 超声造影；类风湿关节炎；活动期；腕关节；诊断价值 　　[中图分类号] R593.2；R445 [文献标识码] B [文章编号] 1673-9701（2017）35-0117-05 　　[Abstract] Objective To study the diagnostic value of contrast-enhanced ultrasound in the active stage of rheumatoid arthritis complicated with carpal arthritis. Methods A total of 35 patients with rheumatoid arthritis who were admitted to the department of rheumatology in our hospital from July 2014 to June 2016 were selected. All patients were admitted due to the complaints of wrist swelling and pain， which were all in the active stage of disease. All patients were given contrast-enhanced ultrasound. Enhanced synovial thickness after contrast-enhanced ultrasound and synovial thickness under two-dimensional ultrasound were measured. The synovial ultrasound contrast perfusion was graded. The correlations between quantitative indices such as synovial thickness， perfusion grade of contrast-enhanced ultrasound and DAS28， laboratory indexes and perfusion grade of contrast-enhanced ultrasound and TIC of contrast-enhanced ultrasound were analyzed statistically. Results The thickness of synovial membrane after contrast-enhanced ultrasound was significantly thicker than that under two-dimensional ultrasound（P0.05）； of the 35 joints， 33 active joints were detected by the blood flow observed by contrast-enhanced ultrasound， accounting for 94.3% of the total； the thickness of synovial membrane， perfusion grade of contrast-enhanced ultrasound and DAS28， EST and CRP were significantly correlated（P0.05）. The thickness of synovial membrane and perfu