Lai Kuo-Lung, Li Pai-Chi
Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.
Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Ultrasonography. 2024 Nov;43(6):478-489. doi: 10.14366/usg.24095. Epub 2024 Sep 2.
This study aimed to evaluate the ability of ultrafast power Doppler (PD) to assess disease activity in rheumatoid arthritis (RA) by examining the correlations between variables from ultrafast PD perfusion imaging and clinical measures of disease activity.
Thirty-three RA patients underwent clinical assessments of disease activity and ultrasound scans of bilateral wrists using both ultrafast and conventional PD systems. A spatial singular value decomposition filter was applied to the ultrafast PD imaging. Singular vectors representing perfusion and fast flows were selected to produce perfusion images. All images were quantitatively analyzed with computer assistance and scored semiquantitatively (0-3) by a physician for synovial vascularity. The Pearson correlation coefficients between image variables and clinical indices were calculated.
The correlation coefficients ranged from weakly to moderately positive between ultrafast PD variables and clinical indices (r=0.221-0.374, all P<0.05). The strongest correlations were observed for synovial PD brightness with the 28-joint Disease Activity Score based on C-Reactive Protein (DAS28-CRP) and the Simplified Disease Activity Index (SDAI). In patients within the deep clinical remission (dCR) subgroup, synovial PD brightness showed stronger correlations with DAS28-CRP, the Clinical Disease Activity Index, and SDAI (r=0.578-0.641, all P<0.001). The correlation coefficients between conventional PD variables and clinical indices were similar to those observed with ultrafast PD variables.
Ultrafast PD imaging effectively extracts capillary blood signals and generates perfusion images. In the RA population, ultrafast PD variables exhibit weak-to-moderate correlations with clinical indices, with these correlations being notably stronger in dCR patients.
本研究旨在通过检查超快速功率多普勒（PD）灌注成像变量与疾病活动临床指标之间的相关性，评估超快速PD评估类风湿性关节炎（RA）疾病活动的能力。
33例RA患者接受了疾病活动的临床评估，并使用超快速和传统PD系统对双侧手腕进行了超声扫描。对超快速PD成像应用空间奇异值分解滤波器。选择代表灌注和快速血流的奇异向量以生成灌注图像。所有图像均在计算机辅助下进行定量分析，并由一名医生对滑膜血管进行半定量评分（0-3分）。计算图像变量与临床指标之间的Pearson相关系数。
超快速PD变量与临床指标之间的相关系数范围为弱至中度正相关（r=0.221-0.374，均P<0.05）。滑膜PD亮度与基于C反应蛋白的28关节疾病活动评分（DAS28-CRP）和简化疾病活动指数（SDAI）之间观察到最强的相关性。在深度临床缓解（dCR）亚组的患者中，滑膜PD亮度与DAS28-CRP、临床疾病活动指数和SDAI之间的相关性更强（r=0.578-0.641，均P<0.001）。传统PD变量与临床指标之间的相关系数与超快速PD变量观察到的相似。
超快速PD成像有效地提取毛细血管血信号并生成灌注图像。在RA人群中，超快速PD变量与临床指标呈现弱至中度相关性，在dCR患者中这些相关性明显更强。
