Consistency analysis of micro-flow imaging and contrast-enhanced ultrasound in evaluating the condition and synovial blood flow of patients with rheumatoid arthritis
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摘要:
目的 采用微血流成像和超声造影检测滑膜血流情况，并分析2种影像学检查方法在评估类风湿性关节炎患者病情中的一致性。 方法 选取2019年7月—2022年10月于湖州市第三人民医院接受治疗的50例类风湿关节炎活动期患者作为研究对象。所有患者均采用微血流成像和超声造影检查，记录患者的滑膜血流情况，并在患者接受治疗6个月后再次采用微血流成像和超声造影评价患者的滑膜血流情况，采用Spearman分析研究其结果与实验室指标的相关性。 结果 治疗前，微血流成像与超声造影2种检查方式在活动期患者的血流信号检出率(Kappa=0.730，P＜0.05)与滑膜血流评价(Kappa=0.797，P＜0.05)方面均具有一致性；治疗6个月后，微血流成像与超声造影2种检查方式在缓解期患者的血流信号检出率(Kappa=0.845，P＜0.05)与滑膜血流评价(Kappa=0.741，P＜0.05)方面均具有一致性；活动期和缓解期的微血流成像和超声造影均与红细胞沉降率、CRP、类风湿因子水平呈正相关(P < 0.05)，且微血流成像的相关性较超声造影更强。 结论 微血流成像和超声造影在类风湿性关节炎患者活动期及缓解期的滑膜血流评估中均具有较强的一致性，且均对病情评估具有临床指导意义。 Abstract:Objective To detect synovial blood flow by micro-flow imaging and contrast-enhanced ultrasound, and analyze the consistency of the two imaging methods in evaluating the condition of patients with rheumatoid arthriti. Methods A total of 50 patients with active rheumatoid arthritis who were treated in Huzhou Third Municipal Hospital from July 2019 to October 2022 were selected as the research objects. All patients were examined by micro-flow imaging and contrast-enhanced ultrasound, and the synovial blood flow of patients was recorded. After 6 months of treatment, the synovial blood flow of patients was evaluated by micro-flow imaging and contrast-enhanced ultrasound again, and the correlation between the results and laboratory indexes was analyzed by Spearman. Results Before treatment, the detection rate of blood flow signals in active patients (Kappa=0.730, P < 0.05) and synovial blood flow evaluation (Kappa=0.797, P < 0.05) were strongly consistent with each other in the micro-flow imaging and contrast-enhanced ultrasound. After 6 months ' treatment, the detection rate of blood flow signals (Kappa=0.845, P < 0.05) and synovial blood flow evaluation (Kappa=0.741, P < 0.05) of patients in remission were both consistent in the micro-flow imaging and contrast-enhanced ultrasound. Micro-flow imaging and contrast-enhanced ultrasound were positively correlated with erythrocyte sedimentation rate, CRP and rheumatoid factor levels in both active and remission stages (P < 0.05), and the correlation of micro-flow imaging was stronger than that of contrast-enhanced ultrasound. Conclusion Micro-flow imaging and contrast-enhanced ultrasound have strong consistency in the assessment of synovial blood flow in patients with rheumatoid arthritis in active stage and remission stage, and both have clinical guiding significance for disease assessment. -
表 1 治疗前微血流成像和超声造影的检查结果比较(个)
Table 1. Comparison of the results of micro-flow imaging and contrast-enhanced ultrasound before treatment
微血流成像 超声造影 合计 阳性 阴性 阳性 45 2 47 阴性 0 3 3 合计 45 5 50 
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表 2 治疗前微血流成像和超声造影的血流评价比较(例)
Table 2. Comparison of blood flow evaluation between micro-flow imaging and contrast-enhanced ultrasound before treatment(cases)
微血流成像 超声造影 合计 0级 1级 2级 3级 0级 3 0 0 0 3 1级 2 13 0 0 15 2级 0 3 18 0 21 3级 0 0 2 9 11 合计 5 16 20 9 50
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表 3 治疗6个月后微血流成像和超声造影的检查结果比较(个)
Table 3. Comparison between micro-flow imaging and contrast-enhanced ultrasound after 6 months of treatment
微血流成像 超声造影 合计 阳性 阴性 阳性 32 2 34 阴性 0 7 7 合计 32 9 41
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表 4 治疗6个月后微血流成像和超声造影的血流评价比较(例)
Table 4. Comparison of blood flow evaluation between micro-flow imaging and contrast-enhanced ultrasound after 6 months of treatment(cases)
微血流成像 超声造影 合计 0级 1级 2级 3级 0级 6 1 0 0 7 1级 3 18 0 0 21 2级 0 1 7 1 9 3级 0 0 1 3 4 合计 9 20 8 4 41
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表 5 微血流成像和超声造影结果与实验室指标的相关性
Table 5. Correlation between the results of micro-blood flow imaging and contrast-enhanced ultrasound and laboratory indexes
实验室指标 微血流成像 超声造影 rs值 P值 rs值 P值 活动期ESR 0.529 < 0.001 0.476 < 0.001 活动期CRP 0.542 < 0.001 0.511 < 0.001 活动期RF 0.614 < 0.001 0.540 < 0.001 缓解期ESR 0.664 < 0.001 0.637 < 0.001 缓解期CRP 0.688 < 0.001 0.623 < 0.001 缓解期RF 0.538 < 0.001 0.534 < 0.001
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