本文關(guān)鍵詞：高頻超聲對類風(fēng)濕性跟腱病的診斷價值　出處：《中國醫(yī)學(xué)影像學(xué)雜志》2017年09期 　論文類型：期刊論文

  更多相關(guān)文章： 關(guān)節(jié)炎 類風(fēng)濕 跟腱 肌腱病 超聲檢查

【摘要】：目的探討高頻超聲(HFUS)對類風(fēng)濕性關(guān)節(jié)炎(RA)跟腱病的診斷價值。資料與方法回顧性分析67例共93足的跟腱HFUS表現(xiàn),其中健康對照組11例22足(A組),RA跟腱病組36例40足(B組)和非RA跟腱病組20例31足(C組)。應(yīng)用HFUS觀察跟腱部位的灰階聲像圖(GSI)和能量多普勒顯像(PDI)特征分析并比較各組:(1)跟腱GSI異常陽性率;(2)跟腱起點(diǎn)、中點(diǎn)和止點(diǎn)的厚度和寬度;(3)跟骨后滑囊積液檢出率;(4)跟腱內(nèi)血流信號檢出率;(5)血流信號的等級。結(jié)果 (1)跟腱GSI異常陽性率:A組與B組差異無統(tǒng)計(jì)學(xué)意義(χ~2=0.064,P0.05),C組比A組和B組更易出現(xiàn)異常(χ~2=31.601、39.256,P0.05);(2)跟腱徑值測量:C組各點(diǎn)橫切面厚度均較A、B組增大(P0.05),各組間橫切面寬度差異均無統(tǒng)計(jì)學(xué)意義(P0.05);(3)跟骨后滑囊積液檢出率:A組未檢出,B組(55.0%)檢出率高于C組(19.4%),差異有統(tǒng)計(jì)學(xué)意義(P0.05);(4)跟腱內(nèi)血流信號檢出率:A組未檢出,B組(97.5%)檢出率高于C組(45.2%),差異有統(tǒng)計(jì)學(xué)意義(P0.05);(5)血流信號等級:Ⅰ級檢出率B組(7.5%)低于C組(35.5%),Ⅱ級檢出率B組(35.0%)高于C組(9.7%),差異均有統(tǒng)計(jì)學(xué)意義(P0.05),Ⅲ級檢出率僅B組45.0%,C組未檢出。另外對3例PDI顯示Ⅲ級血流信號累及跟腱脂肪墊的患者進(jìn)行穿刺活檢,發(fā)現(xiàn)病理結(jié)果與超聲表現(xiàn)一致。結(jié)論 HFUS診斷RA跟腱病具有較高的應(yīng)用價值,并能夠與非RA原因所致跟腱病進(jìn)行鑒別,可以協(xié)助臨床早診斷、早治療,避免跟腱斷裂等不良進(jìn)展。
[Abstract]:Objective to evaluate the diagnostic value of HFU in the diagnosis of Achilles tendon disease with rheumatoid arthritis (RA). Materials and methods the HFUS findings of Achilles tendon in 67 cases (93 feet) were retrospectively analyzed. The healthy control group included 11 cases (22 feet). Group B (36 cases with RA Achilles tendon disease) and group C (20 cases (31 feet) with non-RA Achilles tendon disease). The gray-scale ultrasonography and energy Doppler imaging of Achilles tendon were observed by HFUS (. The abnormal GSI positive rate of Achilles tendon in each group was analyzed and compared. (2) thickness and width of Achilles tendon starting point, midpoint and stop point; 3) the detection rate of posterior calcaneal skidding sac effusion; 4) detecting rate of blood flow signal in Achilles tendon; Results the abnormal GSI positive rate of Achilles tendon in group A was not significantly different from that in group B (蠂 2 0. 064 P 0. 05). Group C was more prone to abnormal than group A and group B (蠂 2 + 31.601) 39.256U (P 0.05); (2) measuring the diameter of Achilles tendon, the thickness of transverse section in group C was larger than that in group A (P 0.05), and there was no significant difference in the width of transverse section between each group (P 0.05). (3) the positive rate of posterior calcaneal sac effusion was 55.0% in group B (P < 0.05), higher than that in group C (P 0.05). (4) the detection rate of blood flow signal in Achilles tendon was higher in group B than in group C (P 0.05). Blood flow signal grade: the detectable rate of blood flow signal in group B was lower than that in group C (7.5%), and the detection rate of grade 鈪，

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