【摘要】 目的 探讨MRI对早期类风湿性关节炎(rheumatoid arthritis,RA)的诊断价值。方法 对40例早期RA患者(26例为临床确诊,14例为随访确诊)行双手、腕关节MR扫描,观察有无滑膜增厚/血管翳强化、骨侵蚀、骨髓水肿、腱鞘炎和关节积液等征象,同时收集患者的临床症状和实验室指标,分析各种MR征象和临床指标在临床诊断和随访诊断RA的诊断价值。选取10例正常志愿者作对照。结果 MR表现在临床确诊RA组和随访确诊RA组间比较差异无统计学意义(P>0.05);对称性关节肿胀、3处及以上关节肿胀、内分湿因子(RF)及C反应蛋白(CRP)在2组比较差异有统计学意义(P<0.05)。结论 早期RA临床症状、实验室指标不具特征性是延误病情的主要原因,MR增强可显示早期RA的滑膜改变和骨侵蚀,为临床正确诊断和早期治疗提供可靠的依据。更多还原

【Abstract】 Objective To investigate the value of the MRI in the diagnosis of early rheumatoid arthritis(RA).Methods Both hands and wrists of all the 40 patients with early RA(26 patients with clinical diagnosed RA,the other 14 with 6-12 months follow-up diagnosed RA) underwent MR examination.MRI appearances including synovial hyperplasia and/or enhanced pannus,bone erosion,bone marrow edema,tenosynovitis and joint effusion were observed.The clinical data and laboratory examinations were also collected from all subjects.The value of MRI and clinical data were analyzed in diagnosis of RA.Ten healthy volunteers were selected as control group.Results All the MRI features had no significant difference between the clinical diagnosed group and the following diagnosed group(P>0.05).The differences of symmetric swelling joints,three or more swelling joints,CRP and RF had statistical significant difference between the two groups(P<0.05).Conclusion The main reason of misdiagnosis of early RA is that the clinical and laboratory tests are not characteristic.The post-contrast medium administration MR imaging could show the early changes of RA including synovium and bone erosion,which provides a reliable method for the early diagnosis and therapy of RA.更多还原