MRI定性定量分析类风湿关节炎患者手腕部骨关节改变

发布时间：2018-05-03 05:07

本文选题：磁共振成像 + 定性定量分析　；参考：《中国介入影像与治疗学》2017年10期

【摘要】：目的探讨3.0T MRI定性定量分析对类风湿性关节炎(RA)患者手腕部骨关节改变的诊断价值。方法将39例RA患者按病程分为早期组(病程≤24个月,20例)及中晚期组(病程24个月,19例),观察两组MRI滑膜炎、骨髓水肿、骨侵蚀、腱鞘炎征象,并应用昆明理工大学研发的定量分析软件测算滑膜炎、骨髓水肿范围。结果 39例患者(共78侧)的手腕部骨关节中,滑膜炎、骨髓水肿、骨侵蚀、腱鞘炎征象的出现率分别为94.87%(37/39)、64.10%(25/39)、61.54%(24/39)、76.92%(30/39)。滑膜炎在腕关节发生率最高[92.31%(72/78)],骨髓水肿在腕骨发生率最高[61.54%(48/78)],骨侵蚀最易累及三角骨[64.10%(50/78)]。屈肌键腱鞘炎[74.36%(58/78)]与伸肌腱腱鞘炎[61.54%(48/78)]发生率差异无统计学意义(χ2=2.94,P=0.09)。早期组与中晚期组滑膜炎、骨髓水肿、骨侵蚀、腱鞘炎征象出现率差异均无统计学意义(P均0.05)。定量分析显示,早期组与中晚期组间滑膜炎范围及骨髓水肿范围差异均无统计学意义(P均0.05)。结论 3.0T MRI可清楚显示RA手腕部骨关节的改变,通过定量分析软件可为评估疾病严重程度提供更加准确的量化信息。
[Abstract]:Objective to investigate the diagnostic value of 3.0T MRI qualitative and quantitative analysis for wrist bone and joint changes in patients with rheumatoid arthritis (RA). Methods 39 patients with RA were divided into two groups according to their course of disease: early group (20 cases) and middle and late stage group (19 cases). MRI synovitis, bone marrow edema, bone erosion and tenosynovitis were observed in two groups. The quantitative analysis software developed by Kunming University of Technology was used to calculate the range of synovitis and bone marrow edema. Results the occurrence rates of synovitis, bone marrow edema, bone erosion and tenosynovitis in the wrist joints of 39 patients (78 sides) were 94.87 / 37 / 39 and 64.10 / 64.10 / 39 respectively. The incidence of synovitis, bone marrow edema, bone erosion and tenosynovitis were 94.87 / 37 / 39 and 64.10% respectively. The incidence of synovitis in wrist joint was the highest [92.31 / 72 / 78], bone marrow edema was highest in carpal bone [61.54 / 48 / 78], bone erosion was most likely to involve triangular bone [64.1010 / 78]. There was no significant difference in the incidence of flexor tenosynovitis (74.36) and extensor tendon tenosynovitis (61.54) (蠂 22.94). There was no significant difference in synovitis, bone marrow edema, bone erosion and tenosynovitis between the early group and the middle and late stage group (P < 0.05). Quantitative analysis showed that there was no significant difference in the range of synovitis and bone marrow edema between the early group and the middle and late stage group (P < 0.05). Conclusion 3.0T MRI can clearly display the changes of wrist joints in RA. Quantitative analysis software can provide more accurate quantitative information for evaluating the severity of RA.
【作者单位】：云南省第一人民医院MRI科;云南省第一人民医院风湿免疫科;昆明理工大学信息工程与自动化学院;
【基金】：云南省科技计划项目[2017FE468(-127)] 昆医联合专项(2014FB095)
【分类号】：R445.2;R593.22

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