Tang Yuanjiao, Yan Feng, Yang Yujia, Xiang Xi, Wang Liyun, Zhang Lingyan, Qiu Li
Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Clinical Ultrasound Imaging Drug Research Lab, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Ultrasound Med Biol. 2017 May;43(5):884-892. doi: 10.1016/j.ultrasmedbio.2016.12.012. Epub 2017 Feb 7.
Our aim was to analyze the diagnostic performance of shear wave elastography (SWE) in the diagnosis of gouty arthritis (GA) and non-gouty arthritis (non-GA). Thirty-nine patients in the GA group and 55 patients in the non-GA group were included in the study. Based on the echo intensity of the joint lesions, the GA group was subdivided into hypo-echoic GA, slightly hyper-echoic GA and hyper-echoic GA subgroups. Quantitative SWE features were evaluated and receiver operating characteristic analysis was performed. On the basis of the study, the elastic modulus (E), mean elastic modulus (E), minimum elastic modulus (E) and elastic modulus standard deviation (E) were significantly higher in the GA group than in the non-GA group and were highest in the hyper-echoic GA subgroup (p < 0.01 for all). E, E and E were significantly higher in the hyper-echoic GA subgroup than in the hypo-echoic GA subgroup and non-GA group (p < 0.001 for all), and E was significantly higher in the hyper-echoic GA subgroup than in the non-GA group (p = 0.001). E, E, E and E were higher in the hypo-echoic GA subgroup than in the non-GA group, and the differences were significant (p < 0.001 for all). Based on the hypo-echoic GA subgroup and non-GA group, areas under the receiver operating characteristic curves for the prediction of GA were 0.749 for E, 0.877 for E, 0.896 for E and 0.886 for E, with optimal cutoff values of 29.40 kPa for E, 45.35 kPa for E, 67.54 kPa for E and 7.85 kPa for E. Our results indicate that SWE can differentially diagnose GA and non-GA, especially when the ultrasound manifestations are not typical.
我们的目的是分析剪切波弹性成像（SWE）在痛风性关节炎（GA）和非痛风性关节炎（非GA）诊断中的诊断性能。该研究纳入了39例GA组患者和55例非GA组患者。根据关节病变的回声强度，GA组又细分为低回声GA、稍高回声GA和高回声GA亚组。评估了定量SWE特征并进行了受试者操作特征分析。基于该研究，GA组的弹性模量（E）、平均弹性模量（E）、最小弹性模量（E）和弹性模量标准差（E）显著高于非GA组，且在高回声GA亚组中最高（所有p < 0.01）。高回声GA亚组的E、E和E显著高于低回声GA亚组和非GA组（所有p < 0.001），高回声GA亚组的E显著高于非GA组（p = 0.001）。低回声GA亚组的E、E、E和E高于非GA组，差异具有统计学意义（所有p < 0.001）。基于低回声GA亚组和非GA组，预测GA的受试者操作特征曲线下面积，E为0.749，E为0.877，E为0.896，E为0.886，E的最佳截断值为29.40 kPa，E为45.35 kPa，E为67.54 kPa，E为7.85 kPa。我们的结果表明，SWE可以鉴别诊断GA和非GA，尤其是当超声表现不典型时。
