膝类风湿关节炎与骨关节炎的MRI与病理对照研究

刘倩; 张雪宁; 王植; 徐谨; 孟祥虹

中国临床医学影像杂志 ›› 2014, Vol. 25 ›› Issue (8) : 587-591.

论著

膝类风湿关节炎与骨关节炎的MRI与病理对照研究

刘倩1，张雪宁1，王植2，徐谨2，孟祥虹2

作者信息 +

Comparative research of MR imaging between rheumatoid arthritis and osteoarthritis of the knee and correlation with histopathology

LIU Qian1, ZHANG Xue-ning1, WANG Zhi2, XU Jin2, MENG Xiang-hong2

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文章历史 +

摘要

目的：对比分析膝类风湿关节炎（Rheumatoid arthritis，RA）与骨关节炎（Osteoarthritis，OA）的MRI和病理表现特点，进一步分析RA的病变机制。方法：收集我院确诊的行全膝关节置换术（Total knee arthroplasty，TKA）并进行组织病理学检查的RA患者12例和OA患者10例，比较二者的MRI表现以及所对应部位组织病理学的表现特点。结果：膝RA及OA组髌股关节、胫股内侧关节软骨病变差异无统计学意义（P＞0.05），胫股外侧关节软骨病变差异具有显著统计学意义（P＜0.05），胫股内、外关节软骨下骨病变差异具有统计学意义（P＜0.05），膝RA及OA组内、外半月板前角、体部、后角病变差异具有显著统计学意义（P＜0.05）。膝RA关节软骨、软骨下骨及半月板病理学发现大量炎细胞浸润、血管增生，OA组仅见软骨纤维化、半月板基质黏液性变性，少见炎细胞、血管增生。结论：RA组膝关节各部分的破坏程度普遍高于OA组，病理学提示可能与血管炎有关。

Abstract

Objective: To analyze and compare the MRI and pathologic characteristics between rheumatoid arthritis(RA) and osteoarthritis(OA) of the knee, exploring the pathological mechanism of RA. Methods: Fourteen knees in 12 patients with RA and 10 knees in 10 patients with OA were treated by total knee arthroplasty(TKA), which was also correlative with MRI. Results: There was no statistical significance of the injury in articular cartilage of medial tibiofemoral joints and patellofemoral joints between RA and OA(P＞0.05). The injure in articular cartilage of lateral tibiofemoral joints of the knee in RA group was significanily high and more severe than that of the knee in OA group(P＜0.05). The subchondral bone marrow lesions of medial and lateral tibiofemoral joints of the knee in RA group was significanily severe than that of the knee in OA group(P＜0.05). The injury of medial and lateral menisci of the knee in RA group was significanily severe than that of the knee in OA group(P＜0.05). There were a large number of inflammatory cells and blood vessels in the articular cartilage, subchondral bone marrow and menisci in the knee of RA group. While articular cartilage fibrosis and only few inflammayory cells and blood vessels were found in OA group. Conclusions: The degree of destruction of all parts in the knee in RA group was significantly higher than those in OA group, this may be related to vasculitis.

导出引用

刘倩;张雪宁;王植;徐谨;孟祥虹. 膝类风湿关节炎与骨关节炎的MRI与病理对照研究[J]. 中国临床医学影像杂志. 2014, 25(8): 587-591

LIU Qian;ZHANG Xue-ning;WANG Zhi;XU Jin;MENG Xiang-hong. Comparative research of MR imaging between rheumatoid arthritis and osteoarthritis of the knee and correlation with histopathology[J]. Journal of China Clinic Medical Imaging. 2014, 25(8): 587-591

中图分类号： Ｒ593.22 Ｒ684.3 Ｒ445.2