刘明;袁新宇;吴凤岐;闫淯淳;白振华;杨洋;

• 1:首都儿科研究所放射科
• 2:首都儿科研究所风湿科

摘要(Abstract)：

目的总结并比较既往对幼年特发性关节炎髋关节病变的MRI评分方法,结合临床指标对既往方法进行改良,为更准确评估髋关节受累的严重程度提供依据。材料与方法通过万方和PubMed等数据库,对既往报道的JIA髋关节受累的MRI评分方法进行总结,分析和比较。提出髋关节MRI改良评分方法。利用改良后的方法回顾性分析2011年1月至2014年6月间确诊的92例JIA患儿髋关节增强MRI图像,采用组内相关系数验证改良后MRI评分方法,并利用改良评分方法对不同MRI征象间的关系进行分析。P<0.05为差异有统计学差异。结果仅5篇文献与JIA髋关节MRI评分相关。除关节积液、髋关节总得分外,改良的MRI评分方法具有良好的一致性(ICC>0.60,P>0.05)。通过分析MRI征象间的相关性,总结出滑膜炎、骨髓水肿、关节积液为可逆性MRI征象,而骨侵蚀、关节软骨受损、骨骺受损、关节狭窄为不可逆性MRI征象。JIA各亚型MRI评分间差异不具有统计学意义(P>0.05),少关节型6例(0~17分),全身型5例(0~21分),RF(-)多关节型7例(1~19分),RF(+)多关节型8例(1~15分),附着点炎型4例(2~5分)。在ACR的治疗分组中,髋关节MRI能比剩余临床指标更早的发现预后不良指征,尤其在≤4个关节炎组(χ~2=16.80,P<0.01)和≥5个关节炎组(χ~2=4.792,P=0.029)中。结论改良后MRI评分方法较既往方法更具有简单性、可靠性、实用性,是一种有效评估受累程度的方法。

关键词(KeyWords)： 关节炎,幼年型;髋关节;磁共振成像

Abstract:

Keywords:

基金项目(Foundation): 北京市市委、市政府重点工作及区县政府应急项目(编号:Z141100006014004)~~

作者(Author): 刘明;袁新宇;吴凤岐;闫淯淳;白振华;杨洋;

Email:

参考文献(References)：

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