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目的观察初诊类风湿性关节炎(rheumatoid arthritis,RA)患者肩关节及其周围软组织病变高频彩超声像表现,探讨超声对RA肩关节病变的辅助诊断价值。方法初诊RA患者40例(80个肩关节),均行高频彩超检查,观察骨侵蚀、肱二头肌长头肌腱(the long head of the biceps tendon,LBT)、肩关节滑膜囊、肩袖超声表现。结果骨侵蚀27个肩关节,超声声像表现为骨性轮廓不规则、骨表面连续性差及不规则隆起;15个肩关节滑膜增生,滑膜厚度1.3~5.7(3.10±0.29)mm,增厚的滑膜呈低回声或中等回声,内可见血流信号;11个肩关节有积液,关节腔内见不规则液性区;4个肩关节肩袖损伤(3个位于冈上肌腱,1个位于冈下肌腱);13个肩关节有LBT病变,腱鞘增宽呈片状低回声,肌腱增粗呈弥漫性的低回声,肌腱厚度(5.2±0.2)mm。结论高频彩超可较准确地检测RA患者肩关节及其周围软组织病变情况,对RA肩关节滑膜病变有一定辅助诊断价值。
Objective To observe the appearance of soft tissue lesions in the newly diagnosed rheumatoid arthritis (RA) patients by high frequency color Doppler ultrasonography and to evaluate the diagnostic value of ultrasound in the diagnosis of RA shoulder joint disease. Methods Forty patients (80 shoulders) with newly diagnosed RA were examined by high frequency color Doppler echocardiography. The bone erosion, the long head of the biceps tendon (LBT), shoulder synovial capsule Sleeve ultrasound performance. Results The bones invaded 27 shoulder joints. The ultrasonographic findings showed irregular contour of the bony outline, poor continuity of the surface of the bone and irregular bulge. The synovial hyperplasia in 15 shoulders increased from 1.3 to 5.7 (3.10 ± 0.29) mm in thickness Thick synovial hypoechoic or moderate echo, blood flow signals can be seen inside; 11 shoulder joint effusion, joint cavity see irregular liquid region; 4 shoulder rotator cuff injury (3 located in the supraspinatus tendon, 1 in the infraorbicular tendon). Thirteen shoulder joints had LBT lesions. The tendon sheath widened and presented with low echogenicity. The thickening of the tendon was diffuse hypoechoic and the thickness of the tendon was (5.2 ± 0.2) mm. Conclusion High-frequency color Doppler ultrasonography can accurately detect the soft tissue lesions of the shoulder and its surrounding areas in patients with RA, and has some auxiliary diagnostic value on RA shoulder synovial lesions.