摘要
目的探讨超微血流成像(SMI)及能量多普勒超声(PDUS)技术在监测类风湿关节炎(RA)滑膜炎活跃性的应用价值。方法本研究入选60例RA患者,超声检测其双侧腕关节、掌指关节、近端指间关节,对受累关节的增厚滑膜,分别启用SMI及PDUS两种血流模式,分别记录两种技术的滑膜血流显示率和血流分级,并探讨SMI及PDUS血流分级指数与临床上常用于评估RA活跃性的实验室指标ESR、CRP及DSA28评分之间是否具有正相关性。结果(1)在60例RA患者中,共有450个关节滑膜增厚,PDUS血流模式与SMI血流模式对受累关节增厚滑膜的血流显示率分别为71.8%、81.1%,PDUS对于滑膜内低速血流的敏感性明显低于SMI,差异具有统计学意义(P=0.001)。(2)在RA临床缓解期,PDUS对亚临床滑膜炎显示率为42.9%,明显低于SMI的66.7%,差异具有统计学意义(P=0.028)。(3)PDUS与SMI对滑膜血流分级结果的一致性较好(kappa=0.721,P<0.05),但SMI较PDUS能够更敏感的显示滑膜微血管内的低速血流,提高滑膜血流分级。(4)SMI及PDUS的滑膜血流分级指数与临床上常用于评估RA活跃性的实验室指标ESR、CRP、DAS28呈正相关(P<0.05)。结论SMI技术是一种先进的超声成像技术,它可以较PDUS可以更敏感的显示微小血管内的低速血流信号,帮助临床医生判断滑膜炎的活跃性,尤其在评估RA临床缓解期的患者是否存在亚临床滑膜炎,达到真正缓解中有着一定的优势。
Objective To explore the application value of Superb Microvascular Imaging(SMI)and power Doppler ultrasound(PDUS)technology in monitoring the activity of synovitis in rheumatoid arthritis(RA).Methods Sixty patients with rheumatoid arthritis(RA)were selected for this study,and their bilateral wrist joints,metacarpophalangeal joints,and proximal interphalangeal joints were detected by ultrasound.The thickened synovium of the affected joints was evaluated using two blood flow modes,SMI and PDUS,respectively.The synovial blood flow display rate and blood flow grading of the two technologies were recorded,and the SMI and PDUS blood flow grading indices were explored,as well as the laboratory indicators commonly used in clinical practice to evaluate RA activity,ESR Is there a positive correlation between CRP and DSA28 scores.Results(1)Among 60 RA patients,there were 450 joints with synovial thickening.The display rates of PDUS and SMI blood flow patterns on synovial blood flow in affected joints were 71.8%and 81.1%,respectively.The sensitivity of PDUS to lowspeed synovial blood flow was significantly lower than that of SMI,and the difference was statistically significant(P=0.001).(2)During the clinical remission period of RA,the display rate of subclinical synovitis by PDUS was 42.9%,significantly lower than 66.7%by SMI,and the difference was statistically significant(P=0.028).(3)The consistency between PDUS and SMI in the classification of synovial blood flow is good(kappa=0.721,P<0.05),but SMI is more sensitive than PDUS in displaying low-speed blood flow within synovial microvasculature and improving synovial blood flow classification.(4)The synovial blood flow grading index of SMI and PDUS is positively correlated with the laboratory indicators ESR,CRP,and DAS28 commonly used to evaluate RA activity in clinical practice(P<0.05).Conclusion SMI technology is an advanced ultrasound imaging technique that can more sensitively display low-speed blood flow signals within small blood vessels than PDUS,helping clinical doctors determine the activity of synovitis,especially in evaluating whether subclinical synovitis exists in patients in clinical remission of RA,and has certain advantages in achieving true remission.
作者
彭锦锦
吕海霞
PENG Jin-jin;LV Hai-xia(Department of Ultrasound,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,Henan Province,China)
出处
《中国CT和MRI杂志》
2024年第4期154-156,共3页
Chinese Journal of CT and MRI
基金
洛阳市2022年度医疗卫生指导性科技计划项目(2022052Y)。
关键词
类风湿关节炎
超微血流成像
能量多普勒超声
滑膜炎
活动性
Rheumatoid Arthritis
Superb Micro-vascular Imaging
Power Doppler Ultrasound
Synovitis
Activity
