上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (9): 1047-.doi: 10.3969/j.issn.1674-8115.2010.09.007

• 专题报道（影像医学与核医学） • 上一篇    下一篇

类风湿性关节炎患者膝关节软骨病变的超声研究

赵 莲, 李凤华, 王 燕, 杜 晶   

  1. 上海交通大学 医学院附属仁济医院超声医学科, 上海 200001
  • 出版日期:2010-09-25 发布日期:2010-09-27
  • 通讯作者: 李凤华, 电子信箱: proflifh@sina.com。
  • 作者简介:赵 莲（1983—）, 女, 住院医师, 硕士；电子信箱: zhaolianzhl@163.com。
  • 基金资助:

    上海市重点学科建设项目（S30203）

Value of ultrasound of articular cartilage of knee in rheumatoid arthritis

ZHAO Lian, LI Feng-hua, WANG Yan, DU Jing   

  1. Department of Ultrasound, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200001, China
  • Online:2010-09-25 Published:2010-09-27
  • Supported by:

    Shanghai Leading Academic Discipline Project, S30203

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摘要：

目的 探讨超声检查在类风湿性关节炎（RA）患者膝关节软骨病变诊断中的应用价值。方法 选取RA患者43例，按病程分为病程＜5年组（n=19）、病程5～10年组（n=12）和病程＞10年组（n=12）；另取同期该院20名健康自愿者作为对照组。各组分别应用灰阶超声观察膝关节软骨。43例RA患者同时行X线平片检查，其中19例患者另行MRI检查。结果 正常对照组股骨关节面软骨厚度内侧髁为（1.8±0.6） mm，外侧髁为（1.9±0.6）mm，正中沟为（2.5±0.7）mm；RA患者组内侧髁＜1.2 mm，外侧髁＜1.3 mm，正中沟＜1.5 mm。病程＜5年组、病程5～10年组及病程＞10年组超声对软骨病变的检出率分别为21.1%、58.3％和91.7％，三组间比较差异有统计学意义（P<0.01）。43例RA患者(86个膝关节)均行超声和X线检查,超声对软骨检出率为41.9％，X线检出率为0，两种检查方法比较差异有统计学意义（P<0.01）。19例患者同时行超声与MRI检查，超声对软骨病变的检出率为26.3％，MRI检出率为47.4％，两种检查方法比较差异无统计学意义（P＞0.05）。结论 超声能较好地监测RA患者疾病发展过程中膝关节软骨病变，但X线无法辨别软骨病变;超声与MRI在RA患者膝关节软骨病变的诊断中均有良好的应用价值。

关键词: 关节炎, 类风湿, 超声

Abstract:

Objective To investigate the value of ultrasound in diagnosis of diseases of articular cartilage of knees in patients with rheumatoid arthritis (RA). Methods Forty-three patients with RA were selected, and were divided into disease course＜5 year group （n=19）, disease course 5 to 10 years group （n=12）and disease course＞10 year group （n=12）. Besides, another 20 healthy volunteers were served as control group. Articular cartilages of knees were observed by gray scale ultrasound in each group. Forty-three patients with RA underwent X-ray examinations, among whom 19 also received MRI examinations. Results The thickness of medial condyle of articular cartilage of knees in control group was (1.8±0.6) mm, lateral condyle was (1.9±0.6) mm, median sulcus was (2.5±0.7) mm, and that in patients with RA was ＜1.2 mm, ＜1.3 mm and ＜1.5 mm, respectively. The detection rates of diseases of articular cartilage by ultrasound in disease course ＜5 year group, disease course 5 to 10 years group and disease course ＞10 year group were 21.1%, 58.3% and 91.7%, respectively, and there were significant differences among groups （P<0.01）. For the 43 patients with RA (86 knee articulations) the detection rate of diseases of articular cartilage by ultrasound was 41.9%, that by X-ray examinations was 0, and there were significant differences between these two examinations (P<0.01）. In 19 patients undergoing both ultrasound and MRI examinations, the detection rates of diseases of articular cartilage by ultrasound and MRI were 26.3% and 47.4%, respectively, and there was no significant difference between these two examinations （P＞0.05）. Conclusion The pathological changes of articular cartilage in patients with RA could be better detected by ultrasound than X-ray. Both ultrasound and MRI could be used to detect diseases of articular cartilage of knee in patients with RA.

Key words: arthritis, rheumatoid, ultrasound