手部小关节滑膜炎超声诊断的临床研究

目的 探讨超声检查在小关节滑膜炎诊断中的应用价值.方法 应用高分辨力超声对40例类风湿关节炎(RA组)患者的腕关节、掌指关节(MCP)及近端指间关节(PIP)均行双侧对比扫查,观察类风湿关节炎腕关节、掌指关节、指间关节滑膜炎的超声声像表现及血流特点,并与20例健康志愿者(对照组)双側相应关节扫查结果对比.结果 RA组共检出578个关节积液,总检出率72.25%;共检出498个关节滑膜增厚,总检出率62.25%;检出140个关节内血管过度增生,总检出率17.50%.结论 高分辨力超声是手部小关节滑膜炎病变和类风湿关节炎早期诊断简便易行及安全有效的检查方法.

Ultrasonographic diagnosis of articular synovitis in hands

Objective In order to confirm the value of early diagnosis in the rheumatoid arthritis using high resolution freguency(HFUS) ultrasonography and Doppler ultrasund. Methods Eight hundred limb joints of Rheumatoid arthritis in 40 patients and four hundred limb joints in 20 healthy volunteers were studied. In these joints including wrist, metacarpophalangeal and proximal interphalangeal joints, the ultrasonographic characteristics and blood flows in the joints were checked with HFUS. Both right and left side joints were compared each other in every cases. GE System Logiq-9 unit with computed color-coded Doppler sonography system and 10.0 MHz high frepuency linear-array transducer was applied. Sonographic examination was performed directly or indirectly on the surface of the body. Results The ultrasonic characteristics in rheumatoid arthritis included hydrarthrodial effusion, synovial thickening, and increased vasculature. Hydrarthrodial effusion was found in 578 joints and the positive detected rate was 72.25% (578/800). Synovial thickening was in 498 joints with positive detected rate of 62.25%(498/800). Vascular hypergenesis was found in 140 joints(17.50% 140/800). On power Doppler ultrasonography and color Doppler, mild to marked hyperemia was identified as spot-, rod-, or streak-like signals. Conclusions High-resolution ultrasonography is an easy, safe and effective method for the early diagnosis of synovitis in small joints in rheumatoid arthritis.JP4]