Chandel Karamvir, Prakash Mahesh, Sinha Anindita, Sharma Aman, Chouhan Devendra K, Sandhu Manavjit Singh
Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Rheumatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
J Med Ultrasound. 2021 Dec 27;30(1):30-35. doi: 10.4103/jmu.jmu_80_21. eCollection 2022 Jan-Mar.
Synovitis is the underlying pathology in various arthritis, and sometimes, it is difficult to differentiate various arthritis clinically or even by imaging. The purpose of our study was to use shear wave elastography (SWE) to evaluate rheumatoid arthritis (RA) and tubercular (TB) arthritis and to differentiate them using synovial stiffness.
The prospective study was performed on Supersonic Imagine Aixplorer Ultrasound (USG) machine using a linear array probe SL10-2 (2-10 MHz). A total of 29 participants, 15 of RA (ACR/EULAR criteria) and 14 of proven TB arthritis were included. Region of interest of 1 mm was applied on the hypertrophied synovium and quantitative SWE data in form of elasticity (kPa) and velocity (m/s) were measured. Discrete categorical data were presented as n (%). Mean values were recorded along with standard deviation and the range of values. To find a maximal cutoff value of elasticity and velocity - receiver operating characteristic curve were plotted.
The mean elasticity and velocity values were 54.81 ± 10.6 kPa and 4.2 m/s ± 0.42 for RA and 37 ± 10 kPa and 3.4 ± 0.47 m/s for TB group. Significant difference ( < 0.001) was seen in elastic modulus values between rheumatoid and TB group with cutoff of 43.6 kPa to differentiate the two groups (sensitivity - 86.7% and specificity - 80%). Similar significant ( < 0.001) results were seen with velocity values, with cutoff of 3.76 m/s (sensitivity - 86.7% and specificity - 80%).
SWE shows the potential to be a useful adjunct to gray scale and color Doppler USG in differentiating various arthritis on the basis of elastic properties of the synovium. Elastic modulus and velocity are useful SWE quantitative parameters for synovial evaluation and can differentiate RA and TB arthritis.
滑膜炎是多种关节炎的潜在病理表现，有时在临床上甚至通过影像学都难以区分各种关节炎。我们研究的目的是使用剪切波弹性成像（SWE）来评估类风湿关节炎（RA）和结核性（TB）关节炎，并利用滑膜硬度对它们进行鉴别。
前瞻性研究在Supersonic Imagine Aixplorer超声（USG）机器上进行，使用线性阵列探头SL10 - 2（2 - 10 MHz）。总共纳入29名参与者，其中15名符合类风湿关节炎（根据美国风湿病学会/欧洲抗风湿病联盟标准），14名确诊为结核性关节炎。在肥厚的滑膜上设置1毫米的感兴趣区域，并测量以弹性（kPa）和速度（m/s）形式表示的定量SWE数据。离散分类数据以n（%）表示。记录平均值以及标准差和数值范围。为了找到弹性和速度的最大截断值，绘制了受试者工作特征曲线。
类风湿关节炎组的平均弹性值和速度值分别为54.81±10.6 kPa和4.2 m/s±0.42，结核组为37±10 kPa和3.4±0.47 m/s。类风湿组和结核组之间的弹性模量值存在显著差异（<0.001），截断值为43.6 kPa以区分两组（敏感性 - 86.7%，特异性 - 80%）。速度值也有类似的显著（<0.001）结果，截断值为3.76 m/s（敏感性 - 86.7%，特异性 - 80%）。
SWE显示出在基于滑膜弹性特性区分各种关节炎方面，有可能成为灰阶和彩色多普勒USG的有用辅助手段。弹性模量和速度是用于滑膜评估的有用SWE定量参数，并且可以区分类风湿关节炎和结核性关节炎。
Zotero 插件
