Silvestri E, Martinoli C, Onetto F, Neumaier C E, Cimmino M A, Derchi L E
Istituto di Radiologia, Università degli Studi di Genova.
Radiol Med. 1994 Oct;88(4):364-7.
Color-Doppler US was used to study the vascularization of the synovial membrane and of the periarticular tissues of the knee in 14 normal subjects and 15 patients with active rheumatoid arthritis. The normal subjects exhibited few spot signals within the connectival spaces surrounding the knee and adjacent to the femoral condyles and to the tibial plates. The signals were mostly arterial and impedance was high because of the absence of inversion of diastole. A hypervascular pattern was detected in 13/15 patients with rheumatoid arthritis as a result of hyperemia associated with inflammation and synovial neoangiogenesis. In these patients, the signals came mostly from the synovial pannus and the soft tissues surrounding the joint. Spectral analysis detected both venous and arterial waveforms with lower resistance than normal (resistive index ranging 0.65 to 0.76). After local treatment, both venous and low-impedance arterial signals were no longer detectable in 4/9 patients with clinical remission. In conclusion, color-Doppler US can support gray-scale US in the assessment of joint inflammation in rheumatoid arthritis patients. Vascular findings seem to correlate well with local symptoms. Color-Doppler US could make a useful tool for monitoring the clinical activity of the disease in selected joints.
采用彩色多普勒超声研究了14名正常受试者和15名活动性类风湿关节炎患者膝关节滑膜及关节周围组织的血管化情况。正常受试者在膝关节周围及与股骨髁和胫骨平台相邻的结缔组织间隙内显示少量点状信号。这些信号大多为动脉性，由于舒张期无反向血流，阻抗较高。15例类风湿关节炎患者中有13例检测到血管增多模式，这是由炎症和滑膜新生血管形成相关的充血所致。在这些患者中，信号大多来自滑膜血管翳和关节周围软组织。频谱分析检测到静脉和动脉波形，其阻力低于正常（阻力指数范围为0.65至0.76）。局部治疗后，9例临床缓解患者中有4例不再能检测到静脉和低阻抗动脉信号。总之，彩色多普勒超声可辅助灰阶超声评估类风湿关节炎患者的关节炎症。血管表现似乎与局部症状密切相关。彩色多普勒超声可为监测特定关节疾病的临床活动提供有用工具。
