Objective Toexploretheclinicaldiagnosisvalueofthehighfrequencycolordopplerultrasound(HFCDU)character-istiesofwristdamageinpatientswithrheumatoidarthritis(RA).Methods 78patientswithRA(RAgroup)werecollectedfrom June 2012 to December 2012 in the Affiliated Hospital of Inner Mongolia Medical University ,sonogram anatomy changes and syno-vial thickness of bilateral wrist were measured using colorul trasound ,meanwhile the respective data obtained from 50 healthy peo-ple undergoing physical examination(healthy control group);using color doppler flow imaging and color doppler energy ,synovial blood flow of artery resistance index (RI) and pulse index(PI) in synovial were measured and detected according to semi-quantitative method of alder ,and explord the correlations between RI and PI .Results (1)Among the 78 cases(156 joints) with RA ,join thy-drops(65 cases ,122 joints) ,inflammatory exudation(34 cases ,70 joints) ,synovium proliferation(78 cases ,153 joints) ,pannus(37 cases ,69 joints) and bony erosion(29 cases ,58 joints) were found.The thickness of synovial membrane of wrist in RA group was (3 .50 ± 1 .37)mm ,that in healthy control group was(1 .46 ± 0 .32)mm ,the different was statistically significant(P<0 .05) .(2) 64 cases among the 78 patients with RA were detected blood flow signals ,RI progressively reduced with blood flow grade the increas-ion which there was a negative correlation (r= -0 .79 ,P<0 .05);there was no significant correlation between PI and blood flow grade .(3) Ultrasound examination was more sensitive than rheumatoid factor (RF) and X-ray in detection rate of RA (P<0 .05) . Conclusion Ultrasound examination could detecte the pathological changes of wrist in patients with RA which is more sensitive than RF and X-ray ,and it could improve the detection rate of RA which contribute to early diagnosis and reasonable treatment for RA .%目的：探讨高频超声影像学在类风湿性关节炎（R A ）腕关节病变中的诊断价值。方法对内蒙古医科大学附属医院2012年6～12月收治的78例RA患者（RA组）腕关节采用彩色超声诊断仪检测，对照同期50例健康体检人群（健康对照组），观察记录各解剖结构的声像图表现及双侧腕关节滑膜的厚度；应用彩色多普勒血流显像及彩色多普勒能量图技术检测关节滑膜的血流特点：滑膜动脉阻力指数（RI）及搏动指数（PI），按Alde半定量法将滑膜血流丰富程度分为0～3级并探讨其与RI及PI的相关性，观察高频超声对RA腕关节早期病变的临床诊断价值。结果（1）超声显示RA组腕关节存在关节积液（65例，122个）、周围炎性渗出（34例，70个）、滑膜增生（78例，153个）、血管翳（37例，69个）及关节面不规则骨质侵蚀（29例，58个）。RA组腕关节滑膜厚度（3．50±1．37）m m ，健康对照组腕关节滑膜厚度（1．46±0．32）m m ，两组比较差异有统计学意义（ P＜0．05）。（2）64例关节滑膜可探及血流信号，其中RI随着血流分级的增加而逐级减低，与血流分级呈负相关（ r＝-0．79，P＜0．05）；PI随血流分级增加变化不大，二者无相关性；（3）与血清类风湿因子（RF）水平及X线片检查相比，超声检查对RA的检出率更高，差异有统计学意义（P＜0．05）。结论手腕部超声检查能较好地显示RA患者的病理改变，较血清RF水平检测和X线片检测更为敏感，可以提高临床RA患者病变检出率，促进其早期诊断及合理治疗。
展开▼
