摘要
目的:探讨高场强MRI对于手腕类风湿性关节炎(RA)早期改变的诊断价值。方法:选择150例在医院就诊时以关节痛为主诉的患者资料进行回顾性分析,采用高场强MRI诊断为手腕RA的患者纳入观察组(102例),非RA患者纳入对照组(48例),对手腕RA早期改变的诊断价值进行探讨。结果:高场强MRI诊断RA早期改变,滑膜增厚、骨髓水肿、骨侵蚀、关节腔积液和肌腱炎的诊断灵敏度均>60%,诊断的特异度均>50%,其中滑膜增厚的诊断灵敏度达到100%,观察组患者的阳性率均高于对照组,数据差异均具有统计学意义(x^2=108.147,x^2=27.943,x^2=50.473,x^2=51.549,x^2=17.558;P<0.05),滑膜增厚、骨髓水肿、骨侵蚀、关节腔积液和肌腱炎均为对手腕RA诊断的独立影响因素(O R=9.631,OR=10.114,OR=25.867,OR=26.258,OR=14.027;P<0.05)。结论:MRI是对早期手腕RA进行诊断的可靠方法,滑膜增厚、骨髓水肿、骨侵蚀、关节腔积液以及肌腱炎均可以作为诊断的主要征象,可结合患者的临床症状、体征与实验室检查结果进行综合判断。
Objective： To explore the diagnostic value of high field intensity magnetic resonance imaging（MRI） in the early changes of wrist rheumatoid arthritis（RA）. Methods： 150 patients with joint pain were enrolled in the retrospective analysis. And in these patients, the patients with RA who were diagnosed by using high field intensity MRI were divided into observation group（102 cases）, and others were divided into control group（48 cases）. The diagnostic value of high field intensity MRI for the early change of wrist RA were further explored and discussed. Results： The diagnostic sensitivities of early change, synovial thickening, bone marrow edema, bone erosion, arthroedema and myotenositis of high field intensity MRI for RA were higher than 60%, and the diagnostic specificity of them were higher than 50%, and the diagnostic sensitivity of synovial thickening of these indicators even achieved to 100%. The positive rates of these indicators of observation group was significantly higher than that of control group, respectively（x2=108.147, x2=27.943, x2=50.473, x2=51.549, x2=17.558, P〈0.05）. And all of synovial thickening, bone marrow edema, bone erosion, arthroedema and myotenositis were the independent influence factors of early diagnosis of wrist RA（OR=9.631, OR=10.114, OR=25.867, OR=26.258, OR=14.027, P〈0.05）. Conclusion： MRI is one of the reliable methods for diagnosing early wrist RA. Synovial thickening, bone marrow edema, bone erosion, joint effusion and tendonitis can be used as the main symptom in diagnosis. And they can be combined with clinical symptom, sign and laboratory examination results to carry out comprehensive judgment for RA of wrist.
作者
曹燕
刘有云
CAO Yan,LIU You-yun(Department of Radiology, Qinghai Hospital of Traditional Chinese Medicine, Xining 810000, Chin)
出处
《中国医学装备》
2018年第5期59-63,共5页
China Medical Equipment
