Kayadibi Yasemin, Ozguler Yesim, Melikoglu Melike, Esatoglu Sinem Nihal, Kimyon Ugur, Kalyoncu Ucar Ayse, Adaletli Ibrahim, Hatemi Gulen
Cerrahpasa Faculty of Medicine, Department of Internal Medicine, Division of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Cerrahpasa Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey
RMD Open. 2025 Apr 5;11(2):e005382. doi: 10.1136/rmdopen-2024-005382.
Superb microvascular imaging (SMI) provides a more sensitive assessment of small vessels compared with power and colour Doppler ultrasonography (PDUS and CDUS). We aimed to investigate the potential of SMI for use in research and clinical practice in Behçet syndrome (BS) and to gain a better understanding of erythema nodosum (EN) like and superficial thrombophlebitis (STM) lesions using SMI.
We studied 51 patients with BS and 31 patients with non-BS with red palpable lesions on physical examination. B-mode US, CDUS, PDUS and SMI were performed and recorded by the same radiologist and recorded images were additionally evaluated independently by another radiologist. Vessel-wall signal intensity of STM lesions by SMI was graded in four groups according to the percentages of the affected vessel-wall area (Grade 0: no signal, Grade 1: < 25%, Grade 2: 25%-50%, Grade 3: 50%-75% and Grade 4: >75%).
The lesions of 26 patients with BS and 17 patients with non-BS were diagnosed as STM with CDUS. SMI of STM lesions revealed vessel-wall signals in 21/26 patients with BS (81%), in contrast to only 3/17 (18%) patients with non-BS. While 16 of 21 patients with BS (76%) had at least grade 2 signal, only 1 of 3 non-BS had it. Lesions of 25 BS and 11 non-BS were diagnosed as EN by CDUS and SMI showed no vessel-wall signal in these patients.
Evaluation of the vessel wall with SMI in BS may be a promising approach for showing inflammation as an inexpensive, non-invasive and reliable imaging method that does not require a contrast agent.
与能量多普勒超声和彩色多普勒超声（PDUS和CDUS）相比，超微血管成像（SMI）能更敏感地评估小血管。我们旨在研究SMI在白塞病（BS）研究和临床实践中的应用潜力，并通过SMI更好地了解结节性红斑（EN）样和浅表性血栓性静脉炎（STM）病变。
我们研究了51例患有BS的患者和31例体检时有红色可触及病变的非BS患者。由同一位放射科医生进行B型超声、CDUS、PDUS和SMI检查并记录，记录的图像再由另一位放射科医生独立评估。根据受影响血管壁面积的百分比，将SMI检测到的STM病变的血管壁信号强度分为四组（0级：无信号，1级：<25%，2级：25%-50%，3级：50%-75%，4级：>75%）。
26例BS患者和17例非BS患者的病变经CDUS诊断为STM。STM病变的SMI显示，26例BS患者中有21例（81%）出现血管壁信号，相比之下，17例非BS患者中只有3例（18%）出现。21例BS患者中有16例（76%）至少有2级信号，而非BS患者中只有1例有此信号。25例BS患者和11例非BS患者的病变经CDUS诊断为EN，SMI显示这些患者无血管壁信号。
用SMI评估BS患者的血管壁，可能是一种有前景的显示炎症的方法，它是一种廉价、无创且可靠的成像方法，无需使用造影剂。
