类风湿性关节炎:膝关节高频超声及超声造影表现与实验室检查的相关性

目的探讨类风湿性关节炎(RA)膝关节滑膜改变的高频超声及CEUS表现与实验室检查的相关性。方法对72例RA患者及30名正常人行高频超声及彩色多普勒超声观察滑膜状态(包括滑膜厚度、关节积液程度、滑膜血流情况);应用CEUS观察膝关节滑膜微循环情况,并分析其与抗环瓜氨酸肽抗体(Anti-ccp)、类风湿因子(RF)、血沉(ESR)、C-反应蛋白(CRP)的相关性。结果超声示,与正常人比较,RA患者膝关节出现不同程度的滑膜增厚、关节积液增多(P<0.01);CEUS更为清晰地显示滑膜内血管翳形成情况;滑膜厚度与CRP(r=0.36,P<0.001)及ESR(r=0.49,P<0.001)、膝关节髌上囊液体厚度与CRP(r=0.44,P<0.001)及ESR(r=0.52,P<0.001)、滑膜厚度与Anti-ccp均有一定相关性(r=0.44,P=0.033)。结论 RA的高频超声及CEUS表现与实验室检查具有相关性,可在一定程度上为诊断RA提供依据。

Correlation between manifestations of high-frequency ultrasound and CEUS with laboratory examination of knee joints lesions in patients with rheumatoid arthritis

Objective To explore the correlation between synovium changes of high-frequency ultrasound and CEUS with laboratory examination of knee joints lesions in patients with rheumatoid arthritis (RA). Methods The synovium status,including synoyium thickness, degree of hydrops articuli and blood flow circumstance of synovium of 72 patients with RA and 30 health adults were observed by high-frequency ultrasound and color Doppler ultrasonography, and the synovium microcirculation of knee joint of each group was observed with CEUS. Then the correlation between the ultrasonic results and anti-cyclic citrullinated peptide (Anti-ccp), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) of knee joints in RA were analyzed. Results Ultrasonography observed different degrees of synovial thickness, hydrops articuli and so on in knee joints of patients with RA, and statistical difference was observed compared with heatth adults (P<0.01). Ultrasound visualization showed the formation of pannus and synovium thickness had correlation with CRP (r=0.36, P<0.001) and ESR (r=0.49, P<0.001), the width of hydrops articuli had correlation with CRP (r=0.44, P<0.001) and ESR (r=0.52, P<0.001),while synovium thickness had correlation with anti-cyclic citrullinated peptide antibody (r=0.44, P=0.033). Conclusion The high-frequency ultrasonographic and CEUS manifestations of synovium changes of knee joints lesions in patients with RA are relevant with biochemical indicators, therefore can offer evidences for the diagnosis of RA.