摘要
目的探讨彩色多普勒超声对下肢肌腱端病变的评估在早期中轴型脊柱关节病(axSpA)中的诊断价值。资料与方法收集2014年3月—2015年2月于南昌大学第一附属医院就诊的44例早期axSpA患者(病例组)及健康志愿者30例(对照组)。以临床及实验室检查结果为标准,将病例组分为活动组[Bath强直性脊柱炎疾病活动指数(BASDAI)≥6,n=19]和非活动组(BASDAI≤4.0,n=25)。运用彩色多普勒超声观察每个研究对象的双侧下肢10个肌腱端(包括股四头肌腱止点、髌腱起点、髌腱止点、跟腱止点和跖底筋膜止点)。回顾性分析早期ax Sp A患者常见的肌腱端病变类型和易累及部位,比较3组间肌腱端的超声检查阳性率、易累及部位、病变类型所占比例的差异。结果①早期axSpA患者肌腱端病变以滑囊炎(32.0%、56/175)和肌腱增厚(17.1%、30/175)常见,跟腱(33.7%、55/163)是下肢易受累部位;②早期axSpA患者肌腱端异常检出率活动组(44.7%)高于非活动组(31.2%)及对照组(6.0%),组间比较差异有统计学意义(P<0.05);能量多普勒血流信号所占比例在病情活动组(20.2%)与非活动组(8.6%)中差异有统计学意义(P<0.05);两组患者附着点易累及部位差异无统计学意义。结论二维超声联合能量多普勒超声可显示早期axSpA患者下肢附着点病变类型及其易累及部位,可为临床早期诊断axSpA及评估炎症活动度提供一定依据。
Purpose To explore the diagnostic value of ultrasonographyin lower limb enthesopathy lesion in early axial spondyloarthropathy（axSpA）. Materials and Methods Forty-four patients with early axSpA and 30 asymptomatic volunteers were included in the study. Patients were subdivided into active group（19 cases） and inactive group（25 cases） base on clinical and laboratorial results. The inclusion criteria were based on Bath ankylosing spondylitis disease activity index（BASDAI）： patients with average score ≥ 6 were in active group, patients with average score ≤ 4.0 were categorized as inactive. Proximal and distal tendon heads of the lower limb were evaluated with ultrasonography, and retrospectively analyzed for common abnormalities and portions that were easily affected in early axSpA patients. The differences in positive rates of enthesis by ultrasonography, the incidence of abnormalities and the involved entheseal sites among the three groups were compared. Results ① Bursitis（32.0%, 56/175） and tendon thickening（17.1%, 30/175） were common abnormalities in axSpA patients; the distal achilles tendon（33.7%, 55/163） was the most frequently involved. ② The abnormality rates of enthesis in three groups were 44.7% for the active group, 31.2% for the inactive group and 6.0% for the control group. The abnormal power Doppler blood flow signals were different in active（20.2%） and inactive（8.6%） groups with statistical significance（P〈0.05）. The involved entheseal sites were not statistically different. Conclusion 2D ultrasonography and power Doppler imaging show the abnormalities and commonly involved entheseal sites in early axSpA patients. It can provide certain information in diagnosing early axSpA and assessing inflammatory activity.
出处
《中国医学影像学杂志》
CSCD
北大核心
2016年第8期627-631,共5页
Chinese Journal of Medical Imaging
关键词
脊柱疾病
骨关节炎
超声检查
多普勒
彩色
下肢
Spinal diseases
Osteoarthritis
Ultrasonography
Doppler
color
Lower extremity
