Möller Ingrid, Largo Raquel, Bong David A, Filer Andrew, Najm Aurélie, Alivernini Stefano, Terslev Lene, Koski Juhani, Balint Peter, Bruyn George A W, Iagnocco Annamaria, Bruns Alessandra, Uson Jacqueline, Acebes Carlos, Rodríguez Ana, Guillen-Astete Carlos, Herrero-Beaumont Gabriel, Miguel Maribel, Garrido Jesús, D'Agostino Maria Antonietta, Naredo Esperanza
Human Anatomy and Embryology Unit, Department of Pathology and Experimental Therapeutics, Faculty of Medicine and Health Sciences (Bellvitge Campus), University of Barcelona, Barcelona, Spain.
Instituto Poal de Reumatología, Barcelona, Spain.
RMD Open. 2025 Jan 20;11(1):e005065. doi: 10.1136/rmdopen-2024-005065.
To develop an EULAR training model for education in synovial tissue biopsy (STB) under ultrasound guidance (UG) following a stepwise approach: (1) development of educational material on UGSTB in large and small joints; (2) assessment of the validity, reliability and feasibility of the UGSTB educational procedure on cadaveric specimens; (3) validation of this procedure in live patients.
Using a nominal group (NG) and a DELPHI consensus methodology, educational audio-visual (AV) material and minimal requirements for education in UGSTB were developed by an expert panel. Then the experts performed an UGSTB on cadaveric joints using the developed approach. The samples retrieved from the cadaveric joints were confirmed histologically and the procedure was then tested by a group of ultrasonographers with different expertise for feasibility and face validity. The AV material and the practical procedures' phases were subsequently ranked by the experts to finalise the training model for performing UGSTB in patients. The ST retrieved in patients was assessed for tissue quality.
Based on NG and DELPHI processes, educational material and a stepwise standardised cadaver-based training model were developed. The knee was the cadaveric joint with the highest yield of histologically good quality of ST. 90% of the UGSTB from patients showed synovial membrane and 77% intact lining layer.
This EULAR endeavour provided a consensus-based comprehensive educational material and a practical cadaver-based model for training in UGSTB, which has shown feasibility and validity in tissue acquisition in specimens and patients.
采用逐步推进的方法，开发一种用于超声引导下滑膜组织活检（STB）教育的欧洲抗风湿病联盟（EULAR）培训模型：（1）编写关于大关节和小关节超声引导下滑膜组织活检的教育材料；（2）评估在尸体标本上进行超声引导下滑膜组织活检教育程序的有效性、可靠性和可行性；（3）在活体患者中验证该程序。
通过名义小组（NG）和德尔菲共识方法，由一个专家小组开发了教育视听（AV）材料以及超声引导下滑膜组织活检教育的最低要求。然后，专家们使用所开发的方法在尸体关节上进行超声引导下滑膜组织活检。从尸体关节获取的样本进行组织学确认，然后由一组具有不同专业知识的超声检查人员对该程序进行可行性和表面效度测试。随后，专家们对视听材料和实际操作阶段进行排序，以最终确定在患者中进行超声引导下滑膜组织活检的培训模型。对从患者身上获取的滑膜组织进行组织质量评估。
基于名义小组和德尔菲流程，开发了教育材料和逐步标准化的基于尸体的培训模型。膝关节是尸体关节中滑膜组织组织学质量合格率最高的关节。90%的患者超声引导下滑膜组织活检显示有滑膜，77%的滑膜衬里层完整。
EULAR的这项工作提供了基于共识的综合教育材料和实用的基于尸体的超声引导下滑膜组织活检培训模型，该模型在标本和患者的组织获取中已显示出可行性和有效性。
