Department of Ultrasound in Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310009, China.
Research Center of Ultrasound in Medicine and Biomedical Engineering, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310009, China.
J Ultrasound. 2023 Mar;26(1):39-47. doi: 10.1007/s40477-022-00749-1. Epub 2023 Jan 12.
To validate and facilitate ultrasound examinations on rheumatoid arthritis (RA) disease activity measurements in routine clinical practice.
A systematic review and network meta-analysis (NMA) of ultrasound examinations on joints and its correlation with clinical RA disease activity was performed. PubMed, Embase and Cochrane library were searched for literatures published up to May 01st 2021. Bayesian random-effect NMA was conducted to pool the correlations of ultrasonographic assessment scores with composite RA disease activity measurements.
Fifteen studies evaluating twelve different existing ultrasonographic measurements on joints evaluation for RA disease activity scoring were included in this NMA. For comparisons with clinical disease activity index and simplified disease activity index, synovitis gray scale ultrasound 7 joints (GSUS7) demonstrated modest correlation of 0.30[- 0.74, 1.23] and 0.46[- 0.45, 1.15] respectively, followed by synovitis power Doppler ultrasound 7 joints (PDUS7) (0.25[- 0.57, 1.14], 0.31[- 0.46, 1.24]) and power Doppler ultrasound 12 joints (PDUS12) (0.23[- 1.36, 0.83], 0.25[- 1.18, 0.88]). As for disease activity score using 28 joint counts, PDUS12 showed the biggest correlation of 0.53[- 0.09, 1.11], followed by ultrasound 7 joints (US7) (0.50[0.06, 0.93]), PDUS7 (0.49[- 0.24, 1.12]), power Doppler ultrasound 6 joints (PDUS6) (0.42[- 0.29, 1.21]), synovitis PDUS7 (0.47[- 0.09, 1.27]) and synovitis GSUS7 (0.40[0.01, 0.86]).
Comparative validity was observed on fewer joints ultrasonic evaluation for RA disease activity measurements, such as synovitis GSUS7 and synovitis PDUS7. Ultrasonographic measurements can be complementary for clinical RA disease activity measures with clinical efficiency, and technical guidelines were in need for clinical routine practice.
为了在常规临床实践中验证和促进类风湿关节炎（RA）疾病活动测量的超声检查。
对关节超声检查及其与临床 RA 疾病活动的相关性进行了系统评价和网络荟萃分析（NMA）。检索了截至 2021 年 5 月 1 日发表的文献，包括 PubMed、Embase 和 Cochrane 图书馆。采用贝叶斯随机效应 NMA 对关节超声评估评分与复合 RA 疾病活动测量的相关性进行了汇总。
这项 NMA 纳入了 15 项研究，评估了 12 种不同的现有关节超声测量方法，用于 RA 疾病活动评分。与临床疾病活动指数和简化疾病活动指数相比，滑膜炎灰阶超声 7 个关节（GSUS7）的相关性中等，分别为 0.30[-0.74, 1.23]和 0.46[-0.45, 1.15]，其次是滑膜炎功率多普勒超声 7 个关节（PDUS7）（0.25[-0.57, 1.14]，0.31[-0.46, 1.24]）和功率多普勒超声 12 个关节（PDUS12）（0.23[-1.36, 0.83]，0.25[-1.18, 0.88]）。对于使用 28 个关节计数的疾病活动评分，PDUS12 显示出最大的相关性为 0.53[-0.09, 1.11]，其次是超声 7 个关节（US7）（0.50[0.06, 0.93]）、PDUS7（0.49[-0.24, 1.12]）、功率多普勒超声 6 个关节（PDUS6）（0.42[-0.29, 1.21]）、滑膜炎 PDUS7（0.47[-0.09, 1.27]）和滑膜炎 GSUS7（0.40[0.01, 0.86]）。
对于较少关节的超声评估 RA 疾病活动测量，如滑膜炎 GSUS7 和滑膜炎 PDUS7，观察到了比较有效性。超声测量可以与临床 RA 疾病活动测量互补，具有临床效率，需要临床常规实践的技术指南。
