Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 31, 20133, Milano, Italy.
IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.
Radiol Med. 2020 May;125(5):481-490. doi: 10.1007/s11547-020-01141-x. Epub 2020 Feb 4.
To systematically review the current literature concerning the role of superb microvascular imaging (SMI), a novel Doppler technique that enables detection of fine vessels and slow blood flow, in the evaluation of musculoskeletal disorders.
An online search of the literature was conducted for the period 2013 to April 2019 and included original articles written in English language. A data analysis was performed at the end of the literature search.
Eight original articles with prospective design and one with retrospective design were included in this review: 4 studies focused on rheumatoid arthritis, 2 on rheumatoid and other arthritides, 1 on lateral epicondylosis and 2 on carpal tunnel syndrome. Sample size ranged from 26 to 83 patients. Despite some methodological differences, all studies compared the performance of SMI with that of a conventional Doppler technique such as power and color Doppler and found an improvement in vascularity detection with SMI. The main variations were in sample size, evaluated parameters and vascularity interpretation methods. Inter-observer agreement for SMI ranged from moderate to excellent.
SMI is a promising tool for the diagnosis and treatment planning of different musculoskeletal disorders. Future investigations should include larger samples of patients with long-term follow-up.
系统回顾目前关于超级微血管成像（SMI）的文献，这是一种新的多普勒技术，能够检测细微血管和低速血流，用于评估肌肉骨骼疾病。
对 2013 年至 2019 年 4 月期间的文献进行在线检索，纳入英文原创文章。文献检索结束后进行数据分析。
本综述纳入 8 篇前瞻性设计的原创文章和 1 篇回顾性设计的文章：4 项研究聚焦于类风湿关节炎，2 项研究聚焦于类风湿关节炎和其他关节炎，1 项研究聚焦于外侧肱骨髁炎，2 项研究聚焦于腕管综合征。样本量从 26 例到 83 例不等。尽管存在一些方法学差异，但所有研究均比较了 SMI 与常规多普勒技术（如功率多普勒和彩色多普勒）的性能，发现 SMI 提高了对血管的检测能力。主要差异在于样本量、评估参数和血管解读方法。SMI 的观察者间一致性从中度到极好不等。
SMI 是一种有前途的工具，可用于不同肌肉骨骼疾病的诊断和治疗计划。未来的研究应包括更多具有长期随访的患者样本。
