摘要
目的探究磁共振成像(MRI)常规序列与三维扰相脂肪抑制梯度回波(3D-WATS)序列对早期类风湿性关节炎手关节病变的诊断价值。方法前瞻性选取2019年1月至2020年1月丹东市第一医院收治的80例疑似早期类风湿关节炎(RA)手关节病变患者作为研究对象。所有患者入院后分别行MRI常规序列及3D-WATS序列诊断,将诊断结果与病理结果对照,分析不同序列对早期RA手关节病变检出情况以及诊断的敏感性、准确性与特异性。结果病理诊断结果显示,80例患者中52例确诊为RA手关节病变阳性,28例为阴性;经3D-WATS序列诊断显示RA手关节病变阳性49例,阴性26例;MRI常规序列检出RA手关节病变阳性40例、阴性20例。3D-WATS序列诊断RA手关节病变的敏感性(94.23%)、特异性(92.86%)及准确率(93.75%)均显著高于MRI常规序列诊断(76.92%,71.43%,75.00%),差异均有统计学意义(P <0.05);3D-WATS序列对关节滑膜炎、骨侵蚀检出率(87.50%,66.25%)明显高于MRI常规序列(68.75%,50.00%),差异均有统计学意义(P <0.05)。结论 MRI 3D-WATS序列诊断早期类风湿性关节炎手关节病变敏感性、特异性及准确率高,能够有效检出关节滑膜炎、骨侵蚀等情况,优于MRI常规序列诊断,能够为临床治疗提供可靠依据,值得临床推广应用。
Objective To explore the diagnostic value of conventional magnetic resonance imaging( MRI) sequence and three-dimensional spoiled fat suppression gradient echo( 3D-WATS) sequence in the diagnosis of early rheumatoid arthritis hand joint disease. Methods Eighty patients with suspected early-stage rheumatoid arthritis( RA) hand joint disease admitted to the First Hospital of Dandong from January2019 to January 2020 were prospectively selected as the research objects. All patients were diagnosed with conventional MRI sequence and 3D-WATS sequence after admission. The diagnosis results were compared with the pathological results. The sensitivity,accuracy and specificity of different sequences in the detection of early RA hand joint lesions and the diagnosis were analyzed. Results The pathological diagnosis results showed that 52 of the 80 patients were diagnosed with RA hand joint disease positive and 28 were negative;3D-WATS sequence diagnosis showed that RA hand joint disease was positive in 49 cases and negative in 26 cases;MRI routine sequence detected RA hand 40 cases of joint disease were positive and 20 cases were negative. The sensitivity( 94. 23%),specificity( 92. 86%) and accuracy( 93. 75%) of 3D-WATS sequence in the diagnosis of RA hand joint disease were significantly higher than those of MRI conventional sequence diagnosis( 76. 92%,71. 43%,75. 00%),the differences were statistically significant( P < 0. 05);the 3D-WATS sequence in the detection rates of joint synovitis and bone erosion( 87. 50%,66. 25%) were significantly higher than those of the conventional MRI sequence( 68. 75%,50. 00%),and the differences were statistically significant( P < 0. 05). Conclusion MRI 3D-WATS sequence has high sensitivity,specificity and accuracy in the diagnosis of early rheumatoid arthritic hand joint lesions,and can effectively detect synovitis and bone erosion,which is better than conventional MRI sequence diagnosis. It can provide a reliable basis for clinical treatment and is worthy of clinical application.
作者
张贵江
冯宪光
张莉
ZHANG Gui-jiang;FENG Xian-guang;ZHANG Li(Department of Rheumatology,the First Hospital of Dandong,Dandong Liaoning 118000,China;Liaoning Mechanical and Electrical Vocational Technical College,Dandong Liaoning 118009,China)
出处
《临床和实验医学杂志》
2022年第1期94-96,共3页
Journal of Clinical and Experimental Medicine
基金
辽宁省自然科学基金(编号:201802007)。
