73 3%,and59 5%,aspecificityof94 9%,97 7%,and98 6%,apositivepredictivevalueof96 7%, 84 6%,and96 2%,andanegativepredictivevalueof88 1%,95 6%,and80 2%.Co

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1 MedicalJournalofPekingUnionMedicalColegeHospital!"#$%&' 1, 2, 3, 1, !", #$%&:' : ,E mail:qingdai_2000@yahoo.com & ()*+,-()./0 1./ 2345&06789 : 11 ; ()* & +,- 1, <=>?@AB:+,-()CD* E./0 F,G1 HIJKL8 :+,-()M>./067NO () L8+,- 103 () :+,-()CD* E./0 F H 59 2% 11 7% 18 8% 62 1% 14 6% 32 1% +() >./ F PQRS()ST() +-U./ FPQV,RS()V./ FPQU W1 X3, :+,-()CD* E./067Y H 92 2% 73 3% 59 5%, H 94 9% 97 7% 98 6%, 9H 96 7% 84 6% 96 2%,Z 9H 88 1% 95 6% 80 2% ( ()*+-[\4RS()]^ST()_`,+-U./4V./_`,RS()a V./4U./_` G1 H:b, :+()M>./67KcF4P,:RS()aU./ 67Y 4 *+ ;1 ; ()*;()./,-. / R A 0 / (2014) DOI: /j isn ComparisonofUltrasoundandMagneticResonanceImagingintheEvaluationof HandandWristJointInvolvementinRheumatoidArthritis XUZhong hui 1,LENGXiao mei 2,ZHENGFu ling 3,WANGLei 1,DAIQing 1 1 DepartmentofUltrasound, 2 DepartmentofRheumatology, 3 DepartmentofRadiology,PekingUnionMedicalColegeHospital, ChineseAcademyofMedicalSciences&PekingUnionMedicalColege,Beijing100730,China Corespondingauthor:DAIQing Tel: ,E mail:qingdai_2000@yahoo.com Abstract Objective Tocomparethevaluesofultrasoundandmagneticresonanceimaging(MRI)in thediagnosisofhandandwristjointinvolvementinrheumatoidarthritis(ra)patientsandsummarizethedistri butionpaternoftheselesions.methods Atotalof11RAcaseswereincluded.Thedetectionratesofsynovi tis,boneerosion,andtenosynovitisofdiferentjointswerecalculatedbasedonultrasoundandmrifindings.the diagnosticeficiencyofultrasoundwasevaluatedbyusingthemriasgoldenstandard.results Totaly103 jointsand112tendonareaswereevaluated.thedetectionratesofsynovitis,boneerosion,andtenosynovitisof wristandhandjointswere59 2%,11 7%,and18 8% byultrasoundand62 1%,14 6%,and32 1% by MRI.Thedetectionrateofwristjointwashigherthanmetacarpophalangeal(MCP)orproximalinterphalangeal (PIP)joints.Thedetectionrateofextensorlesionswashigherthanthatofflexorlesionsatthewristlevel;atthe MCPlevel,however,thedetectionrateofflexorlesionswashigherthanthatofextensorlesions.Comparedwith MRI,forthediagnosisofsynovitis,boneerosion,andtenosynovitis,theultrasoundhadasensitivityof92 2%, Vol 5No 1 41

2 73 3%,and59 5%,aspecificityof94 9%,97 7%,and98 6%,apositivepredictivevalueof96 7%, 84 6%,and96 2%,andanegativepredictivevalueof88 1%,95 6%,and80 2%.Conclusions Wrist jointinvolvementismorecommonthanmcpandpipjointsinvolvementinrapatients.thetendoninvolvement ismorecommoninextensoratthewristlevel,whileinflexoratthemcplevel.comparedwithmri,thediag nosticeficiencyofultrasoundishigherforwristlesionsthanforhandjointslesions.however,ultrasoundisles sensitiveinthediagnosisofextensorlesionsatthemcplevel. Keywords ultrasound;magneticresonanceimaging;rheumatoidarthritis;jointinvolvement MedJPUMCH,2014,5(1):41-45 ()* (rheumatoidarthritis,ra) >.F4P0.,_ () [\,./ 0. / CD*,CD* % ()E,() # +,-()0 W1 67 0: 3, RA+,-./0,2G1 HIJKL8 : RA+,-()./ RA & 11 ; (67JKH RA 67JK), H, (48 6±7 8) (39~67 ),. (1 7±0 9) (0 5~4 6 ) & +() RS ]^ST() 11; &,,1 &,, 9; & +-,S,2; & +- 1 T T Q 3d 56 7"# 8 PHILIPSiU22 67,, FH 5~12MHz &,,! 2 G ()CD*E : +() +() 1~5RS (metacarpophalangeal, MCP)(),2~5]^ST (proximalinterphalangeal, PIP)(), 2 G * : + 1~6U +R 1~5SV,1~ 5SU +()CD* 67JK:() 2mm;MCP() PIP()CD* 67J K:() 1mm ( 1A,B); * 67JK: 1mm ( 2); * 67JK:,- ;()E 67 JK:= `E 7,H,. -H ( 1A, C) [1 2] 67 : &!"# 1 $%& 9: GE' 1 5T & (,) 4#*+()X+, -./0: (2 3 ),45 (2 3 ),?6H7 8 (9:?,# ; ' )10~15ml - 1 CD* E 0 67JK A _()E C, HE() < AB;B CD4 =HE() <4 >,? ;C HE BONE:E;S:CD* 42 January,2014

3 W1 : ()*+,()./ * 67JK A _, H AB;B * H4 0 BONE:A 1;T: ; SPSS13 0BC D # E: "#0 χ 2 :=>?@AB0 F 34 P<0 05H ( ) 11; & () 103, +() 22,RS() 45,]^ST() 36 ;CD *E L8 H 103 ;./L8 112, +()V 11,+()U 11,R S ( ) V 45, R S ( ) U 45 1 :()./0 F` 1 +( ) >./ F PQRS()ST(),+ -U./ FPQV,RS()V./ FPQU 1 :FG./ (P=0 000) R S ( ) H U (P= 0 031) V./ (P=0 004) 0 F,: I./0 F J (P>0 05) W1 X3, :+,-()CD* E. / Y H 92 2% 73 3% 59 5%, H 94 9% 97 7% 98 6%, 9 H 96 7% 84 6% 96 2%, Z 9 H 88 1% 95 6% 80 2% ( 2) RA 0() K0./ HCD * E./ CD* RA0. /,CD* 0L M () E E,./ / * NO, *0. /H CD*, 0N O _ Q WE 0 X $ P CD*./,:QE 067Y $P,Q RA670% ; 1 G P RA()0R M>. /S,Q % T U [ V WX [3 5] 1 1 :+,-()./0 F./ - ()Y /;Y 1 () Y / ;Y 3 (%) () Y / ;Y 3 (%) CD* W 22/11 17/ /100 15/ /90 9 MCP 45/9 23/6 51 1/ /6 53 3/66 7 PIP 36/9 24/7 66 7/ /7 61 1/ /11 64/ /100 61/ /90 9 E W 22/11 12/8 54 5/ /7 45 5/63 6 MCP 45/9 2/2 4 4/22 2 1/1 2 2/11 1 PIP 36/9 1/1 2 8/11 1 1/1 2 8/ /11 15/8 14 6/ /7 11 7/63 6./ W F 11/11 5/5 45 5/45 5 4/4 36 4/36 4 W E 11/11 8/8 72 7/72 7 7/7 63 6/63 6 MCP F 45/9 18/6 40 0/66 7 9/4 20 0/44 4 MCP E 45/9 7/4 15 6/44 4 1/1 2 2/ /11 36/8 32 1/ /7 18 8/63 6 W:+();MCP:RS();PIP:]^ST();F:V ;E:U Vol 5No 1 43

4 2 :+,-()CD* E./067NO (%)./ - Y 9 Z 9 CD* W MCP PIP E W MCP PIP / W MCP F MCP E W MCP PIP F E:A 1./ F,$ZCD* E [./,+()[\0\F $A ]PQRS() ]^ST() ^ E,1 V Q + ( ) E 0 F H 54 5% 45 5%,_QRS]^ST()E 0 F Q 5% 1 V+()E 0 8; (72 7%) 7; (63 6%),_ 1~2; (11 1% ~22 2%) VRS ]^ST()E RA ()[\,Q?@, G: [\(),` a 4b,) 1 : () Tc $ 0,,Q 0 C, +() 3,-0RS ]^ST() $, Q 67 6 [4,6] 67 G E () :Q RA06 W, RA0. / CD* 1 :CD*06 7 4HY, 103 (),1 64 (62 1%) ( ) C D *, 61 (59 2%)()CD*,5&0 F J H,1 :QCD*067 HY, %H?@670IJK [7], :QCD*0 FW1 X3,FG67Y H 92 2%, H 94 9%;,:RS()CD *067Y 100%,:]^ST()CD*0 67Y H 91 7%; :Q,-() CD*067 0 Y ( RA0 ( E C D*, *Q RA & _`, * 0. / CD*, :() CD* N, ) X(0, V, G:./ KcL8:Q RA067 L N [7 9] J 67./0?@ABH 1 H G % H RA, I J K [10 11], :Q,-./0 F Q1,:Q+()./, 067Y H 84 6% 100%,` :QRS ()asu SV 067Y H 14 3% 50% +-SVSU Y 4, 04H,, =./ RS()aSV 0S S V, G 4,Q 6 * :QRS()a0SU,, G, J, 4 = Q 0 *,SU 4 I, G *, RS()SU./ F _, P F0, P F,:SU./0L8 V +-U./0 FPQV,_RS()aV./0 FPQU, W I [7] F@,# 1 : RA+,- ()./06789, 1 Q +,-()0CD* E./ +()M>./0 F PQRS]^ST( ) +-U./ FPQV,RS()V./ FPQU :Q+()M>. /067Kc W1 J :RS ]^ST()CD*067Kc W1 X,:,S./067Y Q1,^GS U./067Y H, Q. ;Y4,: 0 7? ;, &G RAH, E./4, G 34=>?@AB:E 0 F Q 50,Q \.;0, : 1 Q RA+,-()./ _Kc0L8 44 January,2014

5 W1 : ()*+,()./ < = 0 1 [1] SchmidtWA,SchmidtH,SchickeB,etal.Standardrefer encevaluesformusculoskeletalultrasonography[j].ann RheumDis,2004,63: [2] WakefieldRJ,BalintPV,SzkudlarekM,etal.Musculoskel etalultrasoundincludingdefinitionsforultrasonographicpa thology[j].jrheumatol,2005,32: [3],,. Q ()*0 [J].?@,2011,21: [4] TanYK, stergaardm,conaghanpg.imagingtoolsin rheumatoidarthritis:ultrasoundvsmagneticresonanceimaging [J].Rheumatology,2012,51:vi36 vi42. [5] MotaLM,LaurindoIM,NetoLL,etal.Imagingdiagnosisof earlyrheumatoidarthritis[j].revbrasreumatol,2012, 52: [6] RahmaniM,CheginiH,NajafizadehSR,etal.Detectionof boneerosioninearlyrheumatoidarthritis:ultrasonography andconventionalradiographyversusnon contrastmagnetic resonanceimaging[j].clinrheumatol,2010,29: [7] WakefieldRJ,O ConnorPJ,ConaghanPG,etal.Fingerten dondiseaseinuntreatedearlyrheumatoidarthritis:acompari sonofultrasoundandmagneticresonanceimaging[j].ar thritisrheum,2007,57: [8],,,. ()*,- = [J]. :,2010,7: [9] OgishimaH,TsuboiH,UmedaN,etal.Analysisofsubclin icalsynovitisdetectedbyultrasonographyandlow fieldmag neticresonanceimaginginpatientswithrheumatoidarthritis [J].ModRheumatol,2014,24: [10] McQueenF,BeckleyV,CrabbeJ,etal.Magneticresonance imagingevidenceoftendinopathyinearlyrheumatoidarthritis predictstendonruptureatsixyears[j].arthritisrheum, 2005,52: [11] HovingJL,BuchbinderR,HalS,etal.A comparisonof magneticresonanceimaging,sonography,andradiographyof thehandinpatientswithearlyrheumatoidarthritis[j].j Rheumatol,2004,31: ( T : ) 櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒 ABC2>DE FG H IJK?LMGN >?@ 近日, 中共中央组织部公布了万人计划第一批杰出人才科技创新领军人才和青年拔尖人才的名单北京协和医院感染内科李太生教授凭借在传染病研究领域的突出成就入选第一批科技创新领军人才全国各学科领域第一批入选科技创新领军人才的专家有 72 位, 李太生教授是唯一一位临床医生国家高层次人才特殊支持计划, 亦称万人计划, 是由中组部人社部等 11 个部门和单位于 2012 年 8 月 17 日联合出台的面向国内高层次人才的支持计划, 旨在用 10 年左右时间, 有计划有重点地遴选支持名左右自然科学工程技术哲学社会科学和高等教育领域的杰出人才领军人才和青年拔尖人才, 形成与引进海外高层次人才计划相互补充相互衔接的国内高层次创新创业人才队伍开发体系 ( ) Vol 5No 1 45

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