超声超微血管成像联合萤火虫成像对痛风性关节炎早期诊断价值  

Value of ultrasound superb microvascular imaging combined with MicroPure imaging to the early diagnosis of gouty arthritis

作　　者：齐清华[1] 苏高 段少博 王俊魁[1] 王娇娇[1] 董刚[1] QI Qing-hua;SU Gao;DUAN Shao-bo;WANG Jun-kui;WANG Jiao-jiao;DONG Gang(Department of Ultrasound,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China;Department of Emergency Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China;Department of Health Management,Henan Provincial People's Hospital,Zhengzhou University People's Hospital,Zhengzhou,Henan 450003,China)

机构地区：[1]郑州大学第一附属医院超声科,河南郑州450052 [2]郑州大学第一附属医院急诊外科,河南郑州450052 [3]河南省人民医院郑州大学人民医院健康管理科,河南郑州450003

出　　处：《中华实用诊断与治疗杂志》2023年第4期414-416,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190518)。

摘　　要：目的观察痛风性关节炎患者第一跖趾关节超微血管成像(superb microvascular imaging,SMI)、萤火虫成像(MicroPure imaging,MI)表现,探讨二者联合对痛风性关节炎的早期诊断价值。方法64例痛风性关节炎患者应用高频线阵探头对第一跖趾关节扫查,观察超声声像特征,灰阶超声模式下记录双轨征、痛风石、聚集体、骨侵蚀、微结晶、滑膜增厚、关节积液数目;观察SMI与能量多普勒检出滑膜血流分级Ⅰ~Ⅲ级关节数,比较二者滑膜血流显示率;比较灰阶超声及MI微结晶显示率。结果SMI检出滑膜血流分级Ⅰ~Ⅲ级关节数54个,能量多普勒检出滑膜血流分级Ⅰ~Ⅲ级关节数39个,SMI滑膜血流显示率(84.38%)高于能量多普勒(60.94%)(χ^(2)=12.480,P=0.006)。MI微结晶显示率(76.56%)高于灰阶超声(43.75%)(χ^(2)=14.374,P<0.001)。结论SMI易发现早期微血流及滑膜炎症情况,MI可检出微结晶,二者联合检查有助于痛风性关节炎早期诊断。Objective To observe the performance of superb microvascular imaging(SMI)and MicroPure imaging(MI)of the first metatarsophalangeal joint of patients with gouty arthritis,and to discuss the diagnostic value of the combination of these two methods.Methods Sixty-four patients with gouty arthritis were examined by linear array high-frequency probe on the first metatarsophalangeal joint to observe ultrasound imaging characteristics.Double-track signs,gout stones,aggregations,bone erosion,microcrystals,thickened synovium,and joint effusion were recorded under gray scale ultrasound mode.The numbers of joint with synovial blood flow gradeⅠ-Ⅲunder SMI and energy Doppler were observed,and their synovial blood flow display rates were compared.The microcrystal display rates under gray scale ultrasound and MI were compared.Results The SMI display rate of synovial blood flow gradeⅠ-Ⅲ(84.38%,54 joints)was higher than that of energy Doppler(60.94%,39 joints)(χ^(2)=12.480,P=0.006).The display rate of microcrystals under MI was 76.56%,higher than that under gray scale ultrasound(43.75%)(χ^(2)=14.374,P<0.001).Conclusion SMI can detect early microblood flow and synovitis,MI can detect microcrystals,and the combined evaluation of them two contributes to the early diagnosis of gouty arthritis.

关 键 词：痛风性关节炎 超微血管成像 萤火虫成像 第一跖趾关节 

分 类 号：R445.1[医药卫生—影像医学与核医学] R589.7[医药卫生—诊断学]