超声对类风湿关节炎患者腕关节病变诊断价值.docVIP

超声对类风湿关节炎患者腕关节病变诊断价值 　　【摘 要】目的：探讨超声对类风湿关节炎患者腕关节病变的诊断价值。方法：随机选取类风湿关节炎患者55例作为观察组，30例健康成年人作为对照组，分别进行腕关节超声检查，并抽取30例观察组患者对其行MRI检查。结果：超声可观察到类风湿关节炎患者腕关节不同程度滑膜增生、关节积液、肌腱腱鞘炎情况，其阳性检出率与MRI相比，差异无统计学意义（P 0.05），具有很高的一致性。MRI对类风湿关节炎患者腕关节骨侵蚀的检出率高于超声检查。结论：超声在诊断类风湿关节炎患者腕关节病变中，发挥着与MRI近乎相等的作用，可为临床对类风湿关节炎患者腕关节病变的诊断提供一种更简单经济的检查方法。 　　【关键词】 关节炎，类风湿；超声；腕关节；MRI检查；诊断 　　doi：10.3969/j.issn.2095-4174.2014.12.002 　　The Diagnostic Value of Ultrasound for Wrist Arthropathy of Patients with Rheumatoid Arthritis 　　ZHANG Xiao-ying，TIAN Li，CHEN Rong-jie，AN Chao 　　【ABSTRACT】Objective：To investigate the diagnostic value of ultrasound for the wrist arthropathy of patients with rheumatoid arthritis.Methods：55 cases with rheumatoid arthritis were randomly selected as the observation group and 30 healthy adults were selected as the control group.The wrist ultrasound examination was made for them all to observe the thickness of synovium，blood flow，joint effusion，tendons and bone cortex. 　　30 cases out of the observation group were selected for MRI examination.Results：Ultrasound could be used to observe synovium hyperplasia with different degree，joint effusion and tenosynovitis in patients with rheumatoid arthritis.The difference between the positive rate and the MRI was not significant （P 0.05），while with great consistency.The detection rate of MRI for carpal bone erosion was higher than that of the ultrasonography.Conclusion：Ultrasound in the diagnosis of rheumatoid arthritis patients with carpal lesions played almost the same effect as MRI examination，which could provide a more simple and economic method for clinical diagnosis of wrist joint lesions in patients with rheumatoid arthritis. 　　【Keywords】 arthritis，rheumatoid；ultrasound；wrist joint；MRI examination；diagnosis 　　类风湿关节炎（rheumatoid arthritis，RA）是以慢性进行性关节病变为主的自身免疫性疾病，发病者女性多见，是男性的2.5倍左右[1]，表现为滑膜持续性炎症，累及软骨或骨质时可出现关节畸形。关节破坏是RA致畸的主要原因。关节破坏通常自掌指关节及腕关节等小关节开始，以后侵及大关节。对RA患者进行早期诊断并治疗，从而希望延缓病情的发展。目前RA的诊断主要依赖于临床症状及实验室、CT、MRI等检查，超声检查则很少被作为常规检查手段使用。本研究通过