Soini I, Kotaniemi A, Kautiainen H, Kauppi M
Department of Radiology, Rheumatism Foundation Hospital, Heinola, Finland.
Acta Radiol. 2003 Jan;44(1):72-8.
To assess the significance of ultrasonography (US) in detecting hip joint synovitis in patients with rheumatic diseases.
Forty patients with rheumatic disease and suspected hip joint synovitis underwent MRI and US of the hip joint. In addition to the throughout MRI evaluation, the anterior collum-capsule distance (CCD) was determined by both MRI and US. Thirteen healthy volunteers were examined with MRI to establish the criteria for normal findings in MRI when classifying hip joints to those with synovitis and those without. MRI was used as a gold standard.
Synovitis was found using MRI in 31 hips of 22 patients (9 patients had bilateral synovitis). The intraclass correlation was 0.61 between MRI and US in measuring CCD. In classifying hip joint synovitis with US, the sensitivity of the method was 87% and specificity 42%, when the CCD criterion for synovitis was determined to be > or = 7 mm. If the cut-off point was raised to 9 mm, the sensitivity decreased to 61% while specificity increased to 94%. A difference in CCD of > or = 1 mm between the hips as an additional criterion for synovitis increased the number of false-positive findings.
Measurement of CCD with US proved to be a rather inaccurate method to point out synovitis in rheumatic patients when using MRI as a reference. The main reason for this result was the thickened capsule, which US could not differentiate from a thickened synovium.
评估超声检查（US）在检测风湿性疾病患者髋关节滑膜炎中的意义。
40例患有风湿性疾病且疑似髋关节滑膜炎的患者接受了髋关节的MRI和US检查。除了进行全面的MRI评估外，还通过MRI和US测定了前柱-关节囊距离（CCD）。对13名健康志愿者进行了MRI检查，以建立在将髋关节分类为有滑膜炎和无滑膜炎时MRI正常表现的标准。MRI被用作金标准。
在22例患者的31个髋关节中通过MRI发现了滑膜炎（9例患者为双侧滑膜炎）。在测量CCD时，MRI和US之间的组内相关系数为0.61。在用US对髋关节滑膜炎进行分类时，当滑膜炎的CCD标准确定为≥7 mm时，该方法的敏感性为87%，特异性为42%。如果将截断点提高到9 mm，敏感性降至61%，而特异性提高到94%。髋关节之间CCD差异≥1 mm作为滑膜炎的附加标准增加了假阳性结果的数量。
以MRI为参考时，用US测量CCD被证明是一种指出风湿性患者滑膜炎相当不准确的方法。该结果的主要原因是关节囊增厚，US无法将其与增厚的滑膜区分开来。
