[关键词]
[摘要]
目的: 探讨应用高频超声对类风湿性关节炎( RA) 手指关节病变进行定量分析。方法: 选择健康对
照组30 例，RA 病人30 例，应用高频超声检测对比观察掌指关节、指间关节滑膜厚度，血流供应、骨及软骨面及
软组织情况。结果: RA 组共检查出89． 0%的掌指关节，82． 0%近端指间关节，3． 75%远端指间关节滑膜增生，
根据增生的滑膜厚度分级为:厚度＜2 mm 为Ⅰ级，2 mm＜厚度＜4 mm 为Ⅱ级，厚度＞4 mm 为Ⅲ级; 81． 6%的掌指
关节，73． 3%近端指间关节，0． 8%远端指间关节血管过度增生，根据其不同程度分级为: 无血管为0 级，点状血
管为Ⅰ级，带状血管为Ⅱ级，多条带状血管为Ⅲ级。病变关节数的20． 0%见软骨侵蚀，13． 0%见骨侵蚀，58． 6%
见关节腔积液，20． 7%见关节周围软组织肿胀。结论: 高频超声能够显示RA 病变关节的滑膜炎症、血管翳形
成、软骨或骨侵蚀及关节腔积液等病理改变，通过分级诊断为临床诊断、治疗及疗效观察提供详实的影像学资
料，是诊断RA 病人手部关节病变的首选方法之一。
[Key word]
[Abstract]
Objective: To evaluate the imaging of high－frequency ultrasonography( HFUS) in the
diagnosis of finger joints damage in rheumatoid arthritis patients． Methods: HFUS exams of the fingers
were performed in 30 patients( 840 finger joints) with clinically diagnosed RA． Results: On HFUS， synovitis
of 89． 0% articulationes metacarpophalangeae; 82． 0% proximo interphalangeal joints; 3． 75%
distal interphalangeal joints were detected， thickness ＜ 2mm isⅠgrade; 2mm ＜ thickness ＜ 4mm isⅡ
grade; thickness＞4mm is Ⅲ grade; and pannus were detected in 81． 6% articulationes metacarpophalangeae;
73． 3% proximo interphalangeal joints; 0． 8% distal interphalangeal joints． punctiform blood
vessel isⅠgrade; taeniform blood vessel isⅡgrade; many taeniform blood vessel is Ⅲ grade; Cartilage
and bone erosions were found in 20%and 13%joints， intra－articular fluid was found in 58． 6%joints，
periarticular inflammation tissue was detected in 20． 7%joints． Conclusion: Imaging of high frequency
ultrasonography can be reliable in the finger joints damage in RA patients． It can provide a reference for
clinically diagnosed RA．
[中图分类号]
R593． 22; R445． 1
[基金项目]
收稿日期: 2013－01－07; 修回日期: 2013－04－26
基金项目: 内蒙古自然科学基金面上项目( 2010MS1157)
作者简介: 王晓磊( 1976－) ，女，内蒙古医科大学附属医院超声科副主任医师，医学硕士。
通讯作者: 李春阳，主任医师，博士，硕士研究生导师，E－mail:
lichunyang770905@163． com 内蒙古医科大学附属医院神
经内科， 010050
