类风湿关节炎高频超声声像图表现与疾病活动度相关性分析

Correlation analysis of rheumatoid arthritis in high frequency ultrasonography and disease activity

目的探讨类风湿关节炎(rheumatoid arthritis,RA)高频超声二维声像图及微血管成像(super microvascular imaging,SMI)声像图表现与疾病活动度的相关性。方法选择2019年7月至2019年12月间在牡丹江医学院附属红旗医院就诊的RA患者,将其纳入RA组(A组),按照28个关节疾病活动度评分(disease activity score 28,DAS28)将A组分为缓解期组(A1组)及活动期组(A2)。选择同期来我院进行健康体检的10名健康志愿者,将其纳入健康对照组(B组)。对所有研究对象行双腕、第2~4掌指及近端指间关节高频超声检查,观察二维模式下关节滑膜厚度,SMI模式下关节滑膜血流丰富程度并对其进行半定量分级以及滑膜血流阻力指数(resistance index,RI)。结果各组年龄、性别差异无统计学意义(P>0.05);(1)滑膜厚度:A2组滑膜厚度较A1、B组增厚明显(P<0.05);(2)血流指数:A2组血流指数较A1组增加(P<0.05);(3)RI:A2组RI较A1组减低(P<0.05);(4)相关性分析:A组滑膜厚度、血流指数与DAS28呈正相关,RI与DAS28呈负相关(P<0.05)。结论高频超声二维模式能较好显示RA患者手腕关节滑膜增厚情况,SMI能够显示手腕关节滑膜微细血流,且均与DAS28具有一定相关性,因此高频超声能够为临床及时有效的评估RA患者病情提供影像学依据。

Objective To investigate the correlation between disease activity of rheumatoid arthritis(RA)and high-frequency ultrasound two-dimensional ultrasound and microvascular imaging(super microvascular imaging,SMI).Methods RA patients treated in Hongqi Hospital Affiliated to Mudanjiang Medical College from July to December 2019 were included in the RA group(group A),and according to 28 joint disease activity scores(disease activity score 28,DAS28),the RA group was further divided into the remission period group(A1)and the active period group(A2).10 healthy volunteers who came to our hospital for physical examination during the same period were selected and included in the healthy control group(B).High-frequency ultrasound examinations of both wrists,second to fourth metacarpal fingers,and proximal interphalangeal joints were performed on all subjects to observe the thickness of the joint synovium in two-dimensional mode,and the abundance of synovial blood flow in SMI,Quantitative classification and synovial blood flow resistance index(resistance index,RI),Perform statistical analysis on the obtained data.Results There was no significant difference in age and gender between groups(P>0.05).(1)Synovial thickness:The thickness of synovial membrane in A2 was significantly thicker than that in A1 and B(P<0.05);(2)blood flow index:The blood flow index of A2 was higher than group A1(P<0.05);(3)RI:RI of A2 was lower than A1(P<0.05).(4)Correlation analysis,synovial thickness、blood flow index of group A and DAS28 It is positively correlated,and it negatively correlated RI with DAS28(P<0.05).Conclusion The two-dimensional high-frequency ultrasound mode can better show the thickening of the synovial membrane of the wrist joint in RA patients,and the SMI can show the fine blood flow of the synovial membrane of the wrist joint.It has a certain correlation with DAS28,so high-frequency ultrasound can provide an imaging basis for clinical,timely and effective evaluation of RA patients.