Stramare Roberto, Raffeiner Bernd, Ciprian Luca, Scagliori Elena, Coran Alessandro, Perissinotto Egle, Fiocco Ugo, Beltrame Valeria, Rubaltelli Leopoldo
Department of Medical Diagnostic Sciences and Special Therapies, University of Padua Medical School, Padua, Italy.
J Clin Ultrasound. 2012 Mar-Apr;40(3):147-54. doi: 10.1002/jcu.21887. Epub 2012 Jan 30.
PURPOSE.: To assess synovial microvascularity in finger joints with rheumatoid arthritis (RA) by contrast-enhanced ultrasound (CEUS), distinguishing between cases of active disease and those in remission; to standardize the technique for software analysis. METHODS.: Fifty-two finger joints of RA patients (26 with active disease and 26 in remission) were immersed in water and examined by CEUS using a fixed probe. Signal intensity curves were calculated with the software. RESULTS.: Contrast enhancement was detectable in all 26 patients with active RA (100%), but not in 25 of 26 patients in remission (96%); one of the latter patients (4%) showed minimal enhancement. The method's sensitivity and specificity in distinguishing active disease from remission were 100% and 96%. The grades of synovial enhancement correlated with clinical disease activity and software flow parameters. The peak contrast levels correlated with clinical activity, a peak of 9% representing the cutoff between remission and active disease. CONCLUSIONS.: CEUS with a fixed probe on finger joints immersed in water detected synovial vascularization in RA, producing results suitable for standardized software analysis and avoiding artifacts.
通过超声造影（CEUS）评估类风湿关节炎（RA）患者手指关节的滑膜微血管情况，区分疾病活动期和缓解期病例；规范软件分析技术。方法：将52例RA患者的手指关节（26例疾病活动期，26例缓解期）浸入水中，使用固定探头进行CEUS检查。用软件计算信号强度曲线。结果：26例活动期RA患者均能检测到造影剂增强（100%），而26例缓解期患者中有25例未检测到（96%）；后一组中有1例患者（4%）显示轻微增强。该方法区分疾病活动期和缓解期的敏感性和特异性分别为100%和96%。滑膜增强等级与临床疾病活动度及软件血流参数相关。造影剂峰值水平与临床活动度相关，9%的峰值代表缓解期和疾病活动期的分界点。结论：将固定探头置于浸入水中的手指关节上进行CEUS检查，可检测RA患者的滑膜血管化情况，结果适用于标准化软件分析且可避免伪像。
