摘要
目的 :进行肌骨超声在痛风性关节炎(Gouty arthritis,GA)和非痛风性关节炎(非GA)中的影像学分析,为GA的诊断提供理论依据。方法 :本组观察对象选择2016年2月～2017年3月于我院就诊的75例GA(132个关节)患者以及75例(130个关节)非GA患者,设为GA组与非GA组。对相应关节进行灰阶超声检查,监测两组病变关节腱鞘炎、滑膜增生、骨面、滑囊、软组织肿胀及骨化情况,采用能量多普勒超声评价炎症反应程度以及骨膜血量情况,比较两组滑膜增生、骨化、骨侵蚀等肌骨超声表现。结果 :GA组有腱鞘炎、双边征、痛风石、关节腔高回声点、韧带内高回声等肌骨超声表现的关节数明显高于非GA组,差异具有统计学意义,两组有滑膜增生、骨侵蚀、骨化、异常血流、滑囊炎、软组织肿胀、附着点骨面侵蚀等肌骨超声表现的关节数差异无统计学意义;痛风石超声表现为无回声边缘有不均质的低至高回声软圆形包块,表现为"团块"或"云雾状",图像后方表现为衰减回声或伴有声影;双边征表现为附着于无回声软骨表面的一条高强不规则回声带;关节腔高回声点骨肌超声表现为滑膜上的高强回声点或关节积液中局部高强回声点,关节腔内可呈现"暴风雪样"改变;韧带内高回声表现为中高回声的条带分布有较短且不规则的高强回声带。结论 :部分痛风性关节炎表现为有双边征、痛风石、关节腔高回声点、韧带内高回声等特征性肌骨超声表现,对痛风性关节炎具有一定的诊断价值。
Objective To analyze the imaging features of musculoskeletal ultrasound in Gouty arthritis(GA) and non gouty arthritis(non-GA) patients, so as to provide theoretical basis for the diagnosis of GA. Methods 75 GA patients(132 joints) and 75 non-GA patients(130 joints) treated in our hospital from February 2016 to March 2017 were selected as GA group and non-GA group. The corresponding joints were examined by gray-scale ultrasound. Tenosynovitis, synovial hyperplasia, bone surface, bursa, soft tissue swelling and ossification of the diseased joints were monitored. Energy Doppler ultrasound was used to evaluate the degree of inflammatory reaction and the amount of periosteal blood. The ultrasonic manifestations of synovium hyperplasia, ossification, bone erosion and other musculoskeletal manifestations were compared between the two groups. ResultsThe number of joints with tenosynovitis, double contour sign, tophi, hyperechoic points of the joint cavity, high echo in ligament and other musculoskeletal manifestations in GA group was significantly higher than those of non GA group, the difference was statistically significant;There was no significant difference in the number of joint synovial hyperplasia, bone erosion, ossification, abnormal blood flow, bursitis, soft tissue swelling, attachment bone surface erosion and other musculoskeletal ultrasound manifestations in two groups;The sonographic features showed soft round masses without echo, but with heterogeneous and low and high echo, manifested as 'clumps' or 'cloudy'. The posterior image is attenuated or accompanied by acoustic shadows;The double contour sign is characterized by a high intensity irregular vocal cord attached to the surface of the non echogenic cartilage;The high echo point of the joint cavity showed the high intensity echo points on the synovial membrane or the local high echo points in the joint effusion, ' Storm like ' changes occurred in the joint cavity;The hyperechoic area of the ligament is characterized by the middle and high echo bands wit
作者
赵蓉
印淑均
Zhao Rong;Yin Shu-jun(Chongqing Traditional Chinese Medicine Hospital, Chongqing 400021, China)
出处
《湖南师范大学学报（医学版）》
2018年第6期86-89,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
肌骨超声
痛风性关节炎
非痛风性关节炎
影像学分析
musculoskeletal ultrasonography
gouty arthritis
non-gouty arthritis
imaging analysis
