腕关节磁共振成像在类风湿关节炎早期诊断中的应用价值

目的探讨腕关节磁共振成像（MRI）在类风湿关节炎（RA）早期诊断中的应用价值。方法回顾性分析40例临床确诊为早期RA患者的腕关节X线和MRI影像学表现。结果确诊为早期RA的40例患者中,腕关节X线片显示骨侵蚀8例（20%）,关节积液2例（5%）,未发现滑膜病变、骨髓水肿、腱鞘炎等。MRI表现为滑膜病变（滑膜增生和滑膜炎）20例（50%）,骨髓水肿32例（80%）,骨侵蚀27例（67.5%）,关节积液16例（40%）,腱鞘炎3例（7.5%）。MRI在显示病变关节的滑膜病变、骨髓水肿、骨侵蚀、关节积液等方面与X线比较,其差异有统计学意义（P〈0.05）。结论 MRI可以很好地显示早期RA滑膜和骨质的病变,在RA早期诊断中有很大的应用价值。

Value of wrist joint MR imaging in early diagnosis in rheumatoid arthritis

Objective To investigate the value of wrist joint magnetic resonance（ MR） imaging in early diagnosis in rheumatoid arthritis（ RA）. Methods 40 patients with early RA wrist X- ray and MRI imaging findings were analyzed retrospectively. Results For 40 patients diagnosed with early RA,wrist X- ray showed bone erosion was 8 cases（ 20%）,joint effusion was 2 cases（ 5%）,synovial disease,bone marrow edema and tenosynovitis were not been found. The manifestation of MR imaging included synovial disease（ synovial hyperplasia and synovitis） was 20 cases（ 50%）,bone marrow edema was 32 cases（ 80%）,bone erosion was 27 cases（ 67. 5%）,joint effusion was 16 cases（ 40%）,tenosynovitis was 3 cases（ 7. 5%）. There was significant difference of MR imaging in showing synovial disease,bone marrow edema and bone erosion and joint effusion compared with X- ray. Conclusion Abnormalities of synovium and bone in early RA can be well described on MR imaging. MR imaging has great application value in the early diagnosis of RA.