MedicalJournalofPekingUnionMedicalColegeHospital!"#$%&' 1, 2, 3, 1, 1 1 2 3!", 100730 #$%&:' :010 69155497,E mail:qingdai_2000@yahoo.com & ()*+,-()./0 1./ 2345&06789 : 11 ; ()* & +,- 1, <=>?@AB:+,-()CD* E./0 F,G1 HIJKL8 :+,-()M>./067NO () L8+,- 103 () 112 1 :+,-()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 ; ()*;()./,-. / R445 1 01 A 0 / 1674 9081(2014)01 0041 05 DOI:10 3969/j isn 1674 9081 2014 01 010 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:010 69155497,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
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+,-()./06 789 2 34 2010 8 2012 3 6 RA & 11 ; (67JKH 1987. 0 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 1 @ & (,) 4#*+()X+, -./0: - SET11 @,SPGRT11 @, 1 @ (2 3 ),45 SPGRT11 @ (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
W1 : ()*+,()./6789034-2 * 67JK A _, H AB;B * &, @T 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. / 0 6 7 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 $P,Q RA670% ; 1 G P RA()0R M>. /S,Q RA? @ 6 7 0 % T U [ V WX [3 5] 1 1 :+,-()./0 F./ - ()Y /;Y 1 () Y / ;Y 3 (%) () Y / ;Y 3 (%) CD* W 22/11 17/11 77 3/100 15/10 68 2/90 9 MCP 45/9 23/6 51 1/66 7 24/6 53 3/66 7 PIP 36/9 24/7 66 7/77 8 22/7 61 1/77 8 103/11 64/11 62 1/100 61/10 59 2/90 9 E W 22/11 12/8 54 5/72 7 10/7 45 5/63 6 MCP 45/9 2/2 4 4/22 2 1/1 2 2/11 1 PIP 36/9 1/1 2 8/11 1 1/1 2 8/11 1 103/11 15/8 14 6/72 7 12/7 11 7/63 6./ W F 11/11 5/5 45 5/45 5 4/4 36 4/36 4 W E 11/11 8/8 72 7/72 7 7/7 63 6/63 6 MCP F 45/9 18/6 40 0/66 7 9/4 20 0/44 4 MCP E 45/9 7/4 15 6/44 4 1/1 2 2/11 1 112/11 36/8 32 1/72 7 21/7 18 8/63 6 W:+();MCP:RS();PIP:]^ST();F:V ;E:U Vol 5No 1 43
2 :+,-()CD* E./067NO (%)./ - Y 9 Z 9 CD* W 82 4 80 0 93 3 57 1 MCP 100 0 95 5 95 8 100 0 PIP 91 7 100 0 100 0 85 7 92 2 94 9 96 7 88 1 E W 75 0 90 0 90 0 75 0 MCP 50 0 97 7 50 0 97 7 PIP 100 0 100 0 100 0 100 0 73 3 97 7 84 6 95 6./ W 84 6 100 0 100 0 81 8 MCP F 50 0 100 0 100 0 75 0 MCP E 14 3 100 0 100 0 86 4 59 5 98 6 96 2 80 2 W MCP PIP F E:A 1./ F,$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, -. /? @ 6 7 0 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+,-()./06789 1 _Kc0L8 44 January,2014
W1 : ()*+,()./6789034 < = 0 1 [1] SchmidtWA,SchmidtH,SchickeB,etal.Standardrefer encevaluesformusculoskeletalultrasonography[j].ann RheumDis,2004,63:988 994. [2] WakefieldRJ,BalintPV,SzkudlarekM,etal.Musculoskel etalultrasoundincludingdefinitionsforultrasonographicpa thology[j].jrheumatol,2005,32:24857. [3],,. Q ()*0 [J].?@,2011,21:767 770. [4] TanYK, stergaardm,conaghanpg.imagingtoolsin rheumatoidarthritis:ultrasoundvsmagneticresonanceimaging [J].Rheumatology,2012,51:vi36 vi42. [5] MotaLM,LaurindoIM,NetoLL,etal.Imagingdiagnosisof earlyrheumatoidarthritis[j].revbrasreumatol,2012, 52:757 766. [6] RahmaniM,CheginiH,NajafizadehSR,etal.Detectionof boneerosioninearlyrheumatoidarthritis:ultrasonography andconventionalradiographyversusnon contrastmagnetic resonanceimaging[j].clinrheumatol,2010,29:88391. [7] WakefieldRJ,O ConnorPJ,ConaghanPG,etal.Fingerten dondiseaseinuntreatedearlyrheumatoidarthritis:acompari sonofultrasoundandmagneticresonanceimaging[j].ar thritisrheum,2007,57:115864. [8],,,. ()*,- ()./0 @ = [J]. :,2010,7:450 455. [9] OgishimaH,TsuboiH,UmedaN,etal.Analysisofsubclin icalsynovitisdetectedbyultrasonographyandlow fieldmag neticresonanceimaginginpatientswithrheumatoidarthritis [J].ModRheumatol,2014,24:60 68. [10] McQueenF,BeckleyV,CrabbeJ,etal.Magneticresonance imagingevidenceoftendinopathyinearlyrheumatoidarthritis predictstendonruptureatsixyears[j].arthritisrheum, 2005,52:744 751. [11] HovingJL,BuchbinderR,HalS,etal.A comparisonof magneticresonanceimaging,sonography,andradiographyof thehandinpatientswithearlyrheumatoidarthritis[j].j Rheumatol,2004,31:663 675. ( T :2013 10 30 ) 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 10000 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