膝关节类风湿关节炎的MRI

目的：评估MRI对膝关节类风湿关节炎（RA）各种病变的显示能力及其对临床诊治的意义。材料和方法：对24例RA患者的41个膝关节进行多种序列MR成像，分析其MR表现。结果：所有膝关节均发现存在不同程度MR异常改变（100％）。主要影像学表现包括滑膜增生与血管翳形成、关节囊积液、关节软骨与骨质受侵破坏、半月板与韧带异常、Guo窝囊肿及皮下结节形成等。MR尚能通过血管翳的信号和强化程度判断疾病是否处于活动期。结论：MRI能直接显示膝关节RA不同时期的各种病变。根据MRI表现进行分期不仅可为临床提供诊断依据，还可辅助临床选择适当的治疗方案。

MR Imaging of the Knees with Rheumatoid Arthritis

Purpose: To evaluate the ability of MR imaging on demonstration of various lesions of the knees with RA and its importance for clinical diagnosis and therapy. Materials and Methods: MR imaging was performed on 41 knees in 24 patients with RA by using unenhanced Ti - weighted spin - echo sequence, T2 -weighted turbo - spin - echo sequence, fat - suppressed 3D fast - gradient - echo sequence and enhanced T1 - weighted spin - echo sequence. All MRI manifestations of the 41 knees were reviewed. Results: Various degrees of abnormal changes were found in MR images of all the 41 knees(100%) .The main changes including synovial hyperplasia, pannus formation, joint effusion, articular cartilage destruction, bone erosions, meniscus and ligament lesions, popliteal cysts and subcutaneous nodules formation were depicted clearly by MR imaging. Also the signal intensity of the pannus before and after the injection of contrast agent were proved to be valuable for determination of activity of disease.Conclusion: Various lesions of various stages of the knees with rheumatoid arthritis could be demontrated directly by MR imaging. Staging system according to the MR manifestations not only provides clinical doctors with evidences for diagnosis and differential diagnosis, but also help them to select correct therapeutic plans.