类风湿性关节炎手部小关节病变的声像图表现

目的探讨高频超声在类风湿性关节炎(RA)手部小关节病变检查中的应用价值。方法应用高频超声对23例类风湿性关节炎患者(RA组)的230个掌指关节及184个近端指间关节行双侧对比扫查,检测滑膜厚度、血流供应,观察关节腔、骨面及关节周围软组织情况,并与20例健康志愿者(对照组)双侧相应关节扫查结果对比。结果超声图像可清晰显示RA组指关节积液303个(303/414,73.19%);关节滑膜增生264个(264/414,63.77%);彩色多普勒血流成像及能量多普勒超声均可显示RA组患者病变指关节滑膜血管过度增生,显示率分别为31个(31/303,10.23%),76个(76/303,25.08%);且能量多普勒超声的显示率明显高于彩色多普勒血流成像(P0.01)。结论高频超声可清晰显示手部关节腔积液、关节滑膜增生及关节内血管增生,为临床诊治RA提供重要依据。

Ultrasound appearance of synovium within the small joints of the hands in rheumatoid arthritis

Objective To investigate the high-frequency ultrasound （HFUS） in rheumatoid arthritis （RA） of small joints of hands in patients with the diagnosis of disease. Methods High-resolution ultrasound was used to scan bilateral metacarp0phalangeal joints （MCP） and proximal interphalangeal joints （PIP） in 23 patients with rheumatoid arthritis（ RA group）. Ultrasound findings included synovial thickness, vascularity and association changes of soft tissue around joints. All of these findings were compared with 20 healthy volunteers （control group）. Results Joint effusion was found in 303 joints. Synovial hypertrophy was found in 264 joints, in which 31 joints were shown vascnlarity by color Doppler flow image （CDFI）. This number was increased to 76 joints by using color Doppler energy image （CDE）. Conclusion High- frequency ultrasound can accurately show effusion of the hands joints, synovial proliferation and angiogene- sis, which provide evidence for diagnosis and treatment.