超微血流成像技术评估类风湿关节炎患者手指关节亚临床炎

目的 探讨超微血流成像技术(SMI)评价类风湿关节炎(RA)患者手指关节亚临床活动性炎症反应的应用价值。方法 对临床缓解的30例RA患者480个手指关节(双手2~5指掌指关节和近节指间关节)滑膜区进行SMI检查,半定量评分系统对滑膜区血流进行分级,并与能量多普勒(PDUS)对比分析,比较两种检查结果的一致性。结果 临床缓解的30例患者中,PDUS和SMI显示的缓解率分别为56.67%(17/30)和26.67%(8/30),差异有统计学意义(P=0.035)。在480个受检关节中,PDUS对滑膜区血流信号的显示率为8.54%(41/480),SMI血流信号显示率为12.50%(60/480),差异有统计学意义(P<0.001)。PDUS与SMI对滑膜血流分级结果有高度一致性(Kappa=0.732,P<0.001)。结论 SMI技术可更敏感地显示临床缓解期RA患者手指关节滑膜区异常血流信号。

Superb microvascular imaging evaluation of finger joint with subclinical rheumatoid arthritis patients

Objective To investigate the application value of superb microvascular imaging (SMI) technique in evaluation of subclinical inflammatory of finger joints in patients with rheumatoid arthritis (RA). Methods Thirty patients in clinical remission with 480 finger joints (from second to fifth metacarpophalangeal joints and proximal interphalangeal joints) were examined with SMI and power Doppler ultrasound (PDUS). Color flow signals were graded by the semi-quantitative scoring systems. The consistency between the degree of vascularization on PDUS and SMI was evaluated. Results In 30 patients, the ultrasonic remission rate of PDUS and SMI was 56.67% (17/30) and 26.67% (8/30), which had statistical difference (P=0.035). By using PDUS, abnormal vascularization was presented in 41 of 480 joints (41/480, 8.54%), whereas 60 of 480 joints (60/480, 12.50%) detected abnormal vascularization by using SMI (P<0.001). The consistency between the two technique was statistically high (Kappa=0.732, P<0.001). Conclusion SMI can significantly improve the detection of intraarticular vascularization in the finger joints of patients with subclinical RA.