超微血管成像技术在类风湿关节炎滑膜血管翳中的应用价值

Application of SMI in pannus synoviae of rheumatoid arthritis synovial

目的探讨超微血管成像技术(SMI)在检测类风湿关节炎(RA)患者滑膜血管翳中的应用价值。方法分别用能量多普勒(PDUS)和SMI技术对38例行全膝关节置换术(TKA)的RA患者膝关节髌骨上内侧髁和髌骨上外侧髁的滑膜血流信号进行检测、记录和分级。并且对92个膝关节髌骨上内侧髁和髌骨上外侧髁的滑膜病理进行分级。比较PDUS与SMI对滑膜血管分级的一致性,分析SMI分级与病理分级之间的相关性。结果 38例患者中行TKA的膝关节46个。增厚滑膜内PDUS血流信号显示率为99.0%、SMI血流信号显示率为100.0%。PDUS与SMI滑膜血流信号分级的一致性高(Kappa=0.630,P<0.05)。SMI分级与滑膜病理分级之间具有一定的正相关性(r=0.736,P<0.05)。结论与PDUS相比,SMI对滑膜血流信号的检出率更高,SMI分级与病理分级之间相关性较高。SMI技术对RA患者滑膜的血管翳有良好的检出效果。

Objective To investigate the value of superb microvascular imaging(SMI)for diagnosing pannus synoviae of rheumatoid arthritis(RA).Methods The synovial flow signals of the supraplallar patella and the infrapatellar pouch of38patients with RA undergoing total knee arthroplasty were detected by power Doppler ultrasound(PDUS)and superb microvascular imaging(SMI)respectively.The signals of synovial flow were recorded and graded.Synovial pathology was also graded in92knees of the suprapatellar and subretinal sacs.The consistency of synovial grading was compared between PDUS and SMI,and the correlation between SMI classification and pathological grade was analyzed.Results Among the38patients,46knees were performed total knee arthroplasty.The displaying rate of PDUS blood flow signal was99.0%and that of SMI blood flow signal was100.0%in the thickening synovial memberane.The consistency of PDUS and SMI synovial blood flow signal classifications was high(Kappa=0.630,P<0.05).There was a positive correlation between SMI classification and synovial pathological grade(r=0.736,P<0.05).Conclusion Compared with PDUS,SMI has a high detection rate of synovial flow signals.There is a high correlation between SMI classification and pathological grade.SMI technique has a good detection effect on the synovial membrane of RA patients.