本文選題：幼年型關(guān)節(jié)炎 + 磁共振��； 參考：《中南大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年10期

【摘要】：目的:探討磁共振壓脂序列在檢查幼年型關(guān)節(jié)炎中的應(yīng)用價(jià)值。方法:選擇1 131例幼年型關(guān)節(jié)炎患者的1 601個(gè)有癥狀關(guān)節(jié)行磁共振普通T1加權(quán)像(T1 weighted imaging,T1WI)及T2加權(quán)像(T2 weighted imaging,T2WI)序列與精確頻率反轉(zhuǎn)恢復(fù)(spectral presaturation attenuated inversion recovery,SPAIR)T2壓脂序列檢查。所有圖像由2名高年資放射科醫(yī)生及1名小兒風(fēng)濕免疫科醫(yī)生獨(dú)立進(jìn)行評估,確定關(guān)節(jié)組織病變的形態(tài)和程度,當(dāng)3名醫(yī)師意見不一致時(shí),通過討論達(dá)成一致。結(jié)果:磁共振異常發(fā)現(xiàn)847個(gè),占全部檢查的52.9%;普通序列異常發(fā)現(xiàn)409個(gè),占異常發(fā)現(xiàn)的48.3%;壓脂序列異常發(fā)現(xiàn)816個(gè),占異常發(fā)現(xiàn)96.3%。其中關(guān)節(jié)積液占異常發(fā)現(xiàn)的59.5%,骨髓水腫占異常發(fā)現(xiàn)的39.7%。壓脂序列對幼年型關(guān)節(jié)炎的骨髓水腫、關(guān)節(jié)積液、滑膜增厚、軟骨損傷檢出率高于普通序列(P0.05),普通序列的骨侵蝕檢出率高于壓脂序列(P0.05),兩種序列對關(guān)節(jié)囊腫的檢出率差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:在幼年型關(guān)節(jié)炎磁共振檢查中加用壓脂序列可明顯提高影像學(xué)陽性檢出率;磁共振壓脂序列對幼年型關(guān)節(jié)炎早期病理變化如骨髓水腫和關(guān)節(jié)積液等檢出率高,可為早期診斷幼年型關(guān)節(jié)炎提供依據(jù)。
[Abstract]:Objective: to evaluate the value of Mr lipid-pressing sequence in the diagnosis of juvenile arthritis.All images were independently evaluated by 2 radiologists and 1 pediatric rheumatoid immunologist to determine the shape and extent of joint tissue lesions. When three physicians were not in agreement with each other, an agreement was reached through discussion.Results: there were 847 abnormal magnetic resonance findings (52.9%), 409 normal sequence anomalies (48.3%), 816 abnormal blood pressure sequences (96.33%).Joint effusion accounted for 59.5% of abnormal finding, bone marrow edema accounted for 39.7% of abnormal detection.Effects of lipid compression sequence on bone marrow edema, joint effusion, synovial thickening in juvenile arthritis,The detection rate of cartilage injury was higher than that of common sequence (P 0.05), and the detection rate of bone erosion in common sequence was higher than that of fat compression sequence (P 0.05). There was no significant difference between the two sequences in the detection rate of articular cysts (P 0.05).Conclusion: the positive rate of MRI in juvenile arthritis can be improved by adding lipid compression sequence to juvenile arthritis, and the positive rate of MRI in early pathological changes of juvenile arthritis, such as bone marrow edema and joint effusion, is high.It can provide evidence for early diagnosis of juvenile arthritis.
【作者單位】： 寧波大學(xué)醫(yī)學(xué)院;寧波市婦女兒童醫(yī)院小兒風(fēng)濕免疫科;天津市兒童醫(yī)院風(fēng)濕免疫科;
【基金】：浙江省醫(yī)藥衛(wèi)生平臺研究計(jì)劃(2015ZDA027) 寧波市自然基金(2014A610280)~~
【分類號】：R445.2;R726.8

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