Clinic of Rheumatology, Orthopaedics Traumatology, and Reconstructive Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, LT-01513 Vilnius, Lithuania.
Department of Experimental, Preventive and Clinical Medicine, State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, Lithuania.
Medicina (Kaunas). 2023 Sep 11;59(9):1641. doi: 10.3390/medicina59091641.
: Superb microvascular imaging is an advanced Doppler algorithm that seems to be useful in detecting low-velocity blood flow without using a contrast agent. Increasing evidence suggests that SMI is a more sensitive tool than conventional Doppler techniques for evaluating rheumatic diseases, especially inflammatory arthritis. We aimed to assess the use of SMI in evaluating joints and extraarticular structures. : Two reviewers independently reviewed the literature to provide a global overview of the possibilities of SMI in rheumatology. Original English-language articles published between February 2014 and November 2022 were identified through database (PubMed, Medline, Ebsco, the Cochrane Library, and ScienceDirect) searching, and analysed to summarise existing evidence according to PRISMA methodology. Inclusion criteria covered original research articles reporting applications of SMI on rheumatic diseases and musculoskeletal disorders secondary to rheumatic conditions. Qualitative data synthesis was performed. : A total of 18 articles were included. No systematic reviews fulfilled our inclusion criteria. Most studies focused on characterising the synovial vascularity of rheumatoid arthritis. There have been several attempts to demonstrate SMI's value for evaluating extra-articular soft tissues (fat pads or salivary glands) and large-diameter vessels. The quantitative importance of SMI vascular indices could become a useful non-invasive diagnostic marker. Studies on therapeutic applications are still scarce, and the majority of studies have gaps in reporting the methodology (ultrasound performance technique and settings) of the research. : SMI has proved to be useful in characterising low-flow vascularity, and growing evidence indicates that SMI is a non-invasive and lower-cost tool for prognostic assessment, especially in inflammatory arthritis. Preliminary findings also suggest potential interest in evaluating the effect of treatment.
卓越的微血管成像（Superb microvascular imaging）是一种先进的多普勒算法，似乎可用于检测低速血流，而无需使用造影剂。越来越多的证据表明，SMI 是一种比传统多普勒技术更敏感的工具，可用于评估风湿性疾病，尤其是炎症性关节炎。我们旨在评估 SMI 在评估关节和关节外结构中的应用。
两名审查员独立审查文献，提供 SMI 在风湿病学中的应用的全面概述。通过数据库（PubMed、Medline、Ebsco、Cochrane 图书馆和 ScienceDirect）检索，确定了 2014 年 2 月至 2022 年 11 月期间发表的英文原始文章，并进行了分析，根据 PRISMA 方法总结了现有证据。纳入标准涵盖了报告 SMI 应用于风湿性疾病和风湿性疾病引起的肌肉骨骼疾病的原始研究文章。进行了定性数据综合。
共纳入 18 篇文章。没有满足纳入标准的系统评价。大多数研究都集中在描述类风湿关节炎的滑膜血管生成上。已经有一些尝试证明 SMI 对评估关节外软组织（脂肪垫或唾液腺）和大直径血管的价值。SMI 血管指数的定量重要性可能成为一种有用的非侵入性诊断标志物。治疗应用的研究仍然很少，并且大多数研究在报告研究的超声性能技术和设置方面存在差距。
SMI 已被证明在描述低流量血管生成方面非常有用，越来越多的证据表明 SMI 是一种用于预后评估的非侵入性、低成本工具，特别是在炎症性关节炎中。初步研究结果还表明，它在评估治疗效果方面可能具有潜在的兴趣。
