目的:探讨应用高频超声对类风湿性关节炎(RA)手指关节病变进行定量分析.方法:选择健康对照组30例,RA病人30例,应用高频超声检测对比观察掌指关节、指间关节滑膜厚度,血流供应、骨及软骨面及软组织情况.结果:RA组共检查出89.0％的掌指关节,82.0％近端指间关节,3.75％远端指间关节滑膜增生,根据增生的滑膜厚度分级为:厚度＜2 mm为Ⅰ级,2 mm＜厚度＜4 mm为Ⅱ级,厚度＞4 mm为Ⅲ级；81.6％的掌指关节,73.3％近端指间关节,0.8％远端指间关节血管过度增生,根据其不同程度分级为:无血管为0级,点状血管为Ⅰ级,带状血管为Ⅱ级,多条带状血管为Ⅲ级.病变关节数的20.0％见软骨侵蚀,13.0％见骨侵蚀,58.6％见关节腔积液,20.7％见关节周围软组织肿胀.结论:高频超声能够显示RA病变关节的滑膜炎症、血管翳形成、软骨或骨侵蚀及关节腔积液等病理改变,通过分级诊断为临床诊断、治疗及疗效观察提供详实的影像学资料,是诊断RA病人手部关节病变的首选方法之一.%Objective:To evaluate the imaging of high-frequency ultrasonography (HFUS) in the diagnosis of finger joints damage in rheumatoid arthritis patients.Methods:HFUS exams of the fingers were performed in 30 patients (840 finger joints) with clinically diagnosed RA.Results:On HFUS,synovitis of 89.0％ articulationes metacarpophalangeae ; 82.0％ proximo interphalangeal joints ; 3.75％ distal interphalangeal joints were detected,thickness ＜ 2mm is Ⅰ grade; 2mm ＜ thickness ＜4mm is Ⅱ grade; thickness ＞ 4mm is Ⅲ grade; and pannus were detected in 81.6％ articulationes metacarpophalangeae; 73.3％ proximo interphalangeal joints; 0.8％ distal interphalangeal joints.punctiform blood vessel is Ⅰ grade; taeniform blood vessel is Ⅱ grade ; many taeniform blood vessel is Ⅲ grade; Cartilage and bone erosions were found in 20％ and 13％joints,intra-articular fluid was found in 58.6％ joints,periarticular inflammation tissue was detected in 20.7％ joints.Conclusion:Imaging of high frequency ultrasonography can be reliable in the finger joints damage in RA patients.It can provide a reference for clinically diagnosed RA.
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