超声造影与彩色多普勒超声在类风湿关节炎治疗前后的应用  

Use of contrast-enhanced vs color Doppler ultrasound before and after treatment of rheumatoid arthritis

作　　者：韩彬[1] 刘玉婷 Han Bin;Liu Yuting(Department of Ultrasound,Affiliated Hospital of Shanxi College of Traditional ChineseMedicine,Taiyuan 030024,China)

机构地区：[1]山西中医学院附属医院超声科,太原030024 [2]山西省心血管病医院神经内科

出　　处：《中国药物与临床》2019年第9期1414-1417,共4页Chinese Remedies & Clinics

摘　　要：目的探讨超声造影与彩色多普勒超声在类风湿关节炎(RA)的应用价值。方法观察54例RA患者的68个膝关节治疗前常规超声及超声造影的检查结果,其中50个膝关节治疗后复查,治疗前后进行统计学分析。结果超声造影对RA评估的准确性及敏感性高于彩色多普勒超声的评估。滑膜血管翳阻力指数(RI)随着血流分级的增加,RI逐渐减低,血流分级与RI呈负相关。常规超声显示68个膝关节治疗前髌骨上、内、外侧髁滑膜厚度及髌上囊积液深度与50个膝关节治疗后髌骨上、内、外侧髁滑膜厚度及髌上囊积液深度差异均有统计学意义(P<0.05);治疗前后膝关节滑膜内血流分级结果、超声造影分级结果差异有统计学意义(P<0.05)。超声造影显示治疗后滑膜峰值强度减低,曲线下面积缩小,半降时间缩短,内洗斜率降低,达峰时间延长,各参数治疗前后差异均具有统计学意义(P<0.05)。滑膜面积对超声造影参数具有一定影响,可以提高超声造影对疗效评价的可靠性。结论超声造影与彩色多普勒超声对关节滑膜血流显示率高,尤以超声造影明显,可对RA疾病治疗前后提供更多的客观依据。Objective To investigate the value of contrast-enhanced ultrasound(CEUS) vs color Doppler ultrasound(CDUS) in rheumatoid arthritis(RA). Methods The pretreatment findings of CDUS and CEUS were recorded for 54 RA patients(68 knees). Of these patients, 50 knees underwent CDUS/CEUS review after treatment. There sults were statistically compared with baseline. Results The accuracy and sensitivity of CEUS were signficantly higher than CDUS in the assessment of RA. The synovial vascularity resistance index(RI) gradually decreased along with higher levels of blood flow signals, suggesting a negative correlation between the level of blood flow signal and RI.CDUS showed that the thickness of suprapatellar, medial and lateral condylar synovium and the depth of suprapatellar bursa effusion in 68 knees before treatment were significantly different from those in the 50 knees evaluated after treatment(P<0.05). There were significant differences in the blood flow signal level and CEUS grading between the knees before and after treatment(P<0.05). In 50 treated knees, CEUS showed lowered peak intensity of the synovium,reduced area under the curve, shortened half-fall time, decreased wash-in slope, and the prolonged time to peak, with statistically significant differences compared with baseline(P<0.05). The synovial area showed certain interception with contrast parameters of ultrasound, and might be useful for improving the reliability of CEUS evaluation. Conclusion CEUS and CDUS offer good visualization of the synovial blood flow. Performance of CEUS maybe more favorable in-provide more objective data before and after treatment of RA disease.

关 键 词：超声检查 多普勒 彩色 关节炎 类风湿 关节造影术 

分 类 号：R445.1[医药卫生—影像医学与核医学]