Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No.1, Dongcheng District, Beijing, 100730, China.
Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
Eur Radiol. 2021 May;31(5):3542-3552. doi: 10.1007/s00330-020-07353-z. Epub 2020 Nov 12.
We aimed to assess the clinical value of multimodal photoacoustic/ultrasound (PA/US) articular imaging scores, a novel imaging method which can reflect the micro-vessels and oxygenation level of inflamed joints of rheumatoid arthritis (RA).
Seven small joints were examined by the PA/US imaging system. A 0-3 scoring system was used to semi-quantify the PA and power-Doppler (PD) signals, and the sums of PA and PD scores (PA-sum and PD-sum scores) of the seven joints were calculated. The relative oxygen saturation (SO) values of the inflamed joints were measured and classified into 3 PA+SO patterns. The correlations between the PA/US imaging scores and the disease activity scores were assessed.
Thirty-one patients of RA and a total of 217 joints were examined using the PA/US system. The PA-sum had high positive correlations with the standard clinical scores of RA (DAS28 [ESR] ρ = 0.754, DAS28 [CRP] ρ = 0.796, SDAI ρ = 0.836, CDAI ρ = 0.837, p < 0.001), which were superior to the PD-sum (DAS28 [ESR] ρ = 0.651, DAS28 [CRP] ρ = 0.676, SDAI ρ = 0.716, CDAI ρ = 0.709, p < 0.001). For the patients with high PA-sum scores, significant differences between hypoxia and hyperoxia were identified in pain visual analog score (p = 0.020) and patient's global assessment (p = 0.026). The PA+SO patterns presented moderate and high correlation with PGA (ρ = 0.477, p = 0.0077) and VAS pain score (ρ = 0.717, p < 0.001).
The PA scores have significant correlations with standard clinical scores for RA, and the PA+SO patterns are also related with clinical scores that reflect pain severity. PA may have clinical potential in evaluating RA.
• Multimodal photoacoustic/ultrasound imaging is a novel method to assess micro-vessels and oxygenation of local lesions. • Significant correlations between multimodal imaging parameters and clinical scores of RA patients were verified. • The multimodal PA/US system can provide objective imaging parameters, including PA scores of micro-vessels and relative SO value, as a supplementary to disease activity evaluation.
我们旨在评估多模态光声/超声（PA/US）关节成像评分的临床价值，这是一种新的成像方法，可反映类风湿关节炎（RA）炎症关节的微血管和氧合水平。
使用 PA/US 成像系统检查 7 个小关节。采用 0-3 评分系统对半定量 PA 和功率多普勒（PD）信号进行评分，并计算 7 个关节的 PA 和 PD 评分总和（PA-sum 和 PD-sum 评分）。测量炎症关节的相对氧饱和度（SO）值，并将其分为 3 种 PA+SO 模式。评估 PA/US 成像评分与疾病活动评分之间的相关性。
使用 PA/US 系统检查了 31 例 RA 患者共 217 个关节。PA-sum 与 RA 的标准临床评分（DAS28 [ESR] ρ=0.754，DAS28 [CRP] ρ=0.796，SDAI ρ=0.836，CDAI ρ=0.837，p<0.001）呈高度正相关，优于 PD-sum（DAS28 [ESR] ρ=0.651，DAS28 [CRP] ρ=0.676，SDAI ρ=0.716，CDAI ρ=0.709，p<0.001）。对于 PA-sum 评分较高的患者，在疼痛视觉模拟评分（p=0.020）和患者总体评估（p=0.026）方面，缺氧和富氧之间存在显著差异。PA+SO 模式与 PGA（ρ=0.477，p=0.0077）和 VAS 疼痛评分（ρ=0.717，p<0.001）呈中度和高度相关。
PA 评分与 RA 的标准临床评分有显著相关性，PA+SO 模式也与反映疼痛严重程度的临床评分相关。PA 可能具有评估 RA 的临床潜力。
• 多模态光声/超声成像技术是一种评估局部病变微血管和氧合的新方法。• 验证了多模态成像参数与 RA 患者临床评分之间的显著相关性。• 多模态 PA/US 系统可提供客观的成像参数，包括微血管的 PA 评分和相对 SO 值，作为疾病活动评估的补充。
