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目的比较高频彩色多普勒超声(high-frequency Doppler ultrasonography,HFUS)与MRI在肩关节类风湿滑膜病变诊断中的价值。方法 24例(48肩)肩关节类风湿滑膜病变患者,于同一天行双侧肩关节HFUS检查及MRI检查,比较HFUS与MRI对骨质改变、滑膜增生、关节积液、肩袖损伤、软骨损伤显示率的差异。结果 HFUS对骨质改变、滑膜增生、关节积液的显示率(37.5%、66.7%、70.8%)与MRI(54.2%、68.8%、75.0%)比较差异均无统计学意义(P>0.05),对软骨损伤、肩袖损伤的显示率(25.0%、27.1%)低于MRI(45.8%、50.0%),差异有统计学意义(P<0.05);以MRI检查为标准,HFUS检查对关节积液、肩袖损伤、软骨损伤的符合率为100%,骨质改变中HFUS漏诊11肩、误诊3肩,滑膜增生中HFUS漏诊4肩、误诊3肩。结论 HFUS对肩关节类风湿滑膜病变诊断有一定价值,可用于肩关节类风湿滑膜病变的筛查。
Objective To compare the value of high-frequency color Doppler ultrasonography (HFUS) and MRI in the diagnosis of rheumatoid synovial lesions of the shoulder joint. Methods Twenty-four patients (48 shoulders) with rheumatoid synovial lesions of the shoulder were examined with double-sided HFUS and MRI on the same day. The changes of bone mass, synovial hyperplasia, joint effusion and rotator cuff injury were compared between HFUS and MRI. , Cartilage damage showed the difference. Results There was no significant difference in the expressions of bone mass, synovial hyperplasia and synovial fluid in HFUS between the two groups (37.5%, 66.7%, 70.8%) and MRI (54.2%, 68.8%, 75.0%) ) Showed lower rates of cartilage injury and rotator cuff injury than those of MRI (45.8%, 50.0%, 25.0%, 27.1%) (P <0.05) The coincidence rate of joint effusion, rotator cuff injury and cartilage injury was 100%. 11 cases of missed diagnosis of osteoarthritis in HFUS, 3 cases of misdiagnosis, 4 missed diagnosis of HFUS in synovial hyperplasia and 3 cases of misdiagnosis. Conclusion HFUS has some value in the diagnosis of rheumatoid synovial lesions of the shoulder joint and can be used in the screening of rheumatoid synovial lesions of the shoulder joint.