膝类风湿性关节炎和骨关节炎的MRI表现特点和比较

目的 分析膝关节类风湿性关节炎（RA）和骨关节炎（OA）各自的MRI特点并提出诊断和鉴别诊断方法。材料与方法 77例82个膝OA和25例36个膝RA关节行MRI各个方位的SE T1WI、T2WI和3D－FFE。结果 RA膝关节MRI显示软骨破坏较OA严重而广泛（P＜0．01），OA软骨磨损以承重或摩擦大的部位好发。MRI见RA骨结构改变也较OA广泛（P＜0．01）。OA的滑膜增生比RA局限，通常伴随半月板病变和游离体。结论 根据膝关节各结构病变的程度、部位和范围的差异，MRI对OA和RA的诊断和鉴别诊断有一定的帮助，3D－FFE判断软骨病变具有很高的应用价值。

Rheumatoid Arthritis and Osteoarthritis of the KneeComparison of MRI Features

Objective To analyze the MRI features of rheumatoid arthritis (RA) and osteoarthritis (OA) of the knee, to study the key points in the diagnosis and differentiation.Materials and Methods MR scanning with SE T 1WI, SE T 2WI and 3D FFE sequences was performed for 82 knees in 77 patients with OA and for 36 knees in 25 patients with RA.Results Chondral abrasion in knees with RA was much more severe and extensive than that in knees with OA (P<0.01). Osseous lesion in RA was also more extensive than that in OA (P<0.01). In patients with OA, the synovial hyperplasia was more localized, and abnormal meniscus and/or foreign body were often seen.Conclusion Usually, based on the site, severity and extent of the lesion on MRI, the diagnosis and differentiation of OA and RA can be made. 3D FFE is very valuable in judging chondral lesion.