The Application Value of Superb Microvascular Imaging and Power Doppler Ultrasound in Evaluating the Activity of Rheumatoid Arthritis
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 low-speed 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.
万方数据
维普
