Advanced Power Doppler Technique Increases Synovial Vascularity Detection in Patients with Rheumatoid Arthritis |
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Authors: | Davide Orlandi Salvatore Gitto Silvia Perugin Bernardi Angelo Corazza Luca De Flaviis Enzo Silvestri Marco Amedeo Cimmino Luca Maria Sconfienza |
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Affiliation: | 1. Servizio di Radiologia, Ospedale Evangelico Internazionale, Genova, Italy;2. Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Milan, Italy;3. Scuola di Specializzazione in Radiodiagnostica, Università degli di Genova, Genoa, Italy;4. Unità Operativa di Radiologia Diagnostica ed Interventistica, IRCCS Ospedale Ortopedico Galeazzi, Milan, Italy;5. Studio di Radiologia E. De Flaviis, Milan, Italy;6. Unità Operativa di Reumatologia, Università degli di Genova, Genoa, Italy |
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Abstract: | We compared the diagnostic performance of an advanced power Doppler technique (superb microvascular imaging [SMI]) with that of power Doppler Imaging (PDI) and B-mode ultrasound (US) in patients with early rheumatoid arthritis (RA) and RA under treatment with rituximab. Thirty patients (21 women aged 45 ± 11 y) affected by RA with remission to moderate disease activity were examined. Both hand joints were evaluated using US, PDI and SMI. Two radiologists reviewed all video clips and evaluated synovial vascularity intensity using a semi-quantitative scoring system. SMI revealed the presence of synovial vascularity in a significantly larger number of patients than PDI (p = 0.02). Inter-observer agreement for US, PDI and SMI was moderate (κ = 0.59), very good (κ = 0.87) and very good (κ = 0.82), respectively. We conclude that SMI detects more vessels than PDI in RA patients. This may allow increased sensitivity for early diagnosis of synovial inflammation, monitoring of its dynamic changes under therapy and evaluation of true imaging remission. |
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Keywords: | Ultrasound Power Doppler Superb microvascular imaging Rheumatoid arthritis Synovitis |
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