超声造影与能量多普勒超声在类风湿关节炎患者滑膜炎评估中的应用价值分析  

Effect of contrast-enhanced ultrasonography and power Doppler ultrasonography in the assessment of synovitis in patients with rheumatoid arthritis

作　　者：高辰玮[1] 徐大奎[1] 任占芬[2] GAO Chen-wei;XU Da-kui;REN Zhan-fen(Department of Ultrasound Medicine,the First Affiliated Hospital of Hebei North University,Hebei,Zhangjiakou 075000,China;Department of Rheumatology and Immunology,the First Affiliated Hospital of Hebei North University,Hebei,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院超声医学科,河北张家口075000 [2]河北北方学院附属第一医院风湿免疫科,河北张家口075000

出　　处：《中国医学前沿杂志（电子版）》2020年第1期114-117,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：河北省中医药管理局科研计划项目(2017294)。

摘　　要：目的比较超声造影(contras-enhanced ultrasound,CEUS)和能量多普勒超声(power Doppler ultrasound,PDUS)在类风湿关节炎(rheumatoid arthritis,RA)患者滑膜炎评估中的应用价值。方法选取2018年1月至2019年5月河北北方学院附属第一医院收治的58例RA患者为研究对象,分别进行PDUS和CEUS检查,比较两种检查方法对滑膜炎的诊断结果及其与病情活动度的相关性。结果两种超声技术检出的血管分级结果比较差异有统计学意义(P<0.05),CEUS检出的血管分级0~1级更少,2~3级更多。CEUS检查得到的关节滑膜炎评分显著高于PDUS检查(P<0.05)。两种超声技术检出的血管分级结果、关节滑膜炎评分与C反应蛋白水平、红细胞沉降率、28个关节的疾病活动度评分均呈显著正相关(均P<0.05)。结论CEUS与PDUS均能较好地反映RA患者关节滑膜内的血管形成变化,预测RA的疾病活动程度,且CEUS在检测微血管方面的效果优于PDUS。Objective To compare the value of contrast-enhanced ultrasonography and power Doppler ultrasonography in the assessment of synovitis in patients with rheumatoid arthritis(RA).Method Fifty-eight patients with RA admitted to the First Affiliated Hospital of Hebei North University from January 2018 to May 2019 were enrolled for the study.PDUS and CEUS were used for ultrasound examination successively.The results of the two examinations were compared,and the correlation between the results and the indexes of disease activity was analyzed.Result There was significant difference in the vascular grading between PDUS and CEUS(P<0.05).The vascular grading of CEUS had fewer grades 0~1 and more grades 2~3.The score of synovitis obtained by CEUS was significantly higher than that obtained by PDUS(P<0.05).The blood vessel classification and score of synovitis obtained by PDUS and CEUS were all positively correlated with C-reactive protein,erythrocyte sedimentation rate and disease activity score of 28 joints(all P<0.05).Conclusion Both CEUS and PDUS can well reflect the changes of vascularization in synovium membrane,then predict the disease activity of RA,and CEUS is better than PDUS in detecting microvessel.

关 键 词：类风湿性关节炎 超声造影 能量多普勒超声 血管形成 微血管 

分 类 号：R445.1[医药卫生—影像医学与核医学] R593.22[医药卫生—诊断学]